Breech Presentation
A. Occurs in 25% of pregnancies at 28 weeks.B. Occurs in less than 5% of pregnancies at term.
C. Is associated with fetal abnormality.
D. Is associated with uterine malformation.
E. Is associated with hydramnios.
The answer is. B. Occurs in
less than 5% of pregnancies at term. , C. Is associated with fetal abnormality.
, D. Is associated with uterine malformation E. Is associated with hydramnios
Breech
presentation
A
fetus is said to be in a breech presentation when thebuttocks of the baby are
presenting first at the bottom of theuterus, and the head is in the upper part,
or fundus of theuterus.
There
are three types of breech presentations, frank,complete, and incomplete.
The
frank breech presentation is the most common of thethree and the safest
position for a baby to be in if a vaginaldelivery is to be attempted.
This
occurs in 3-4% of all deliveries.
The
percentage of breech deliveries decreases with advancinggestational age from
22% of births prior to 28 weeks' to 1-3%of births at term.
Predisposing
factors for breech presentation
· Preterm
labor and birth - if labor starts when the baby isstill small enough to move
rather freely in the uterus.
· A
placenta in the fundus - the placenta takes up some ofthe space in the top of
the uterus.
· Uterine
malformations
· Fibroids
in the lower part of the uterus
· More
than one fetus
· Polyhydramnios
or Oligohydroamniosis
· Fetal
abnormalities (eg, CNS malformations, neckmasses, aneuploidy)
· A
very relaxed uterus from many previous children
Vaginal breech delivery: Three
types of vaginal breechdeliveries
1. Spontaneous
breech delivery: No traction or manipulation ofthe infant is used
2. Assisted
breech delivery: This is the most common type ofvaginal breech deliver
3. Total
breech extraction: The fetal feet are grasped, and theentire fetus is extracted
- Total breech extraction should beused only for a noncephalic second twin; it
should not beused for a singleton fetus as it is associated with a birth
injuryrate of 25% and a mortality rate of approximately 10%
A
vaginal delivery may be attempted for a baby in thebreech position if:
ü A
The baby is in a frank breech position
ü The
baby is small enough to pass easily through thevagina
ü No
obstetrical problems, such as placenta previa
ü Pregnant
woman's pelvis is a normal or above averagesize
ü The
baby has already descended well into the pelvis aslabor begins
ü The
baby's head is tucked down toward its chest – notExtended
