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Breech presentation - Coggle Diagram
Breech presentation
Risk factors
Prematurity
Multifetal
Extremes amniotic fluid volumes
Uterine and Fetal anomalies
Placenta previa
Nulliparity
Prior breech
Small gestational age
Consideractions
One-on-one nursing
Monitoring +CTG
Analagesia (manuvers)
Induction / augmentation (not to give inductions it may worse the labor to cs kept go in normal way)
Classification
Frank (most common)
Complete
Incomplete
Diagnosis
Leoplod maneuvers
Cervical examination
US
Vaginal delivery methods
Spontaneous breech delivery (hands off tech.)
Partial breech extraction (buttocks out until ampalicus so will do maneuvers)
Total breech extraction (enter the hand and extract the baby by the feets)
Delivery routes
VD
Parity(not primi)✅
gestational age (term) ✅
Pelvic dimensions(good for VD)?✅
Pregnancy complication❌
Provider experience (available)? ✅
Patient preference ✅
Hospital capabilities (they can do emergency CS if needed)✅
Fetal size (if hydrocephalus or high weight )❌
CS
Lack of operator experience
Patient preference
Prior perinatal death or trauma
Small fetus (2.5-2.8 kg) or large fetus (3.8-4 kg)
Oligohydraminos
Hyperextended neck
Fetal anomaly
Incomplete breech presntation
Preterm (if baby not viable20-22 wks it is gray area not to do cs)
Pelvic shape
Prior CS
Complications
Maternal
Genital tract lacerations
Infection (episiotomy/cut the cervix)
Fetal
Prematurity
Congenital anomalies
Umbilical cord prolapse (near to cervix rather than cephalic )
Humoral ,pelvic fracture
Brachial plexus injury
Changing positions
External cephalic version (external manipulation ) 37wks
Contraindications
Oligohydramnios
Ruptured membranes
Known nuchal cord(around the neck)
Structural utrine abnormalities
Fetal-growth restriction
Multifetal gestation
Prior abruption or risk factor
Early labor
Complications
Uterine rupture
Feto-maternal hemorrhage
Alloimmunization
Amniotic fluid embolism
Maternal /fetal death
internal cephalic version (enter hand to change the position)
Definition
(buttocks/legs entered the pelvis before the head)