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IN
BREECH PRESENTATION
Figure 21-2. Breech presentations. A: Right sacrum posterior (RSP) position. B: Left sacrum
anterior (LSA) position. (Redrawn and reproduced, with permission, from Bumm E: Grundiss zum
Studium der Geburtshilfe. Bergmann, 1922)
PREDISPOSING FACTORS :
Prematurity
Fetal abnormalities
Multiple gestations
: -CNS Malformations;
-Neck Masses
% Breech
21-24
33
25-28
28
29-32
14
33-36
37-40
DIAGNOSIS :
Ultrasound
Pelvic examination
X-Ray studies
Leopold Maneuver
Vaginal delivery:
Spontaneous
Partial
breech extraction
Total breech extraction
Cesarean of delivery
Management
does not
allow sufficient time for molding of the fetal head;
thus, a platypelloid or android pelvis decreases
ability fetal head to navigate maternal pelvis
MORTALITY/MORBIDITY
Increased birth trauma: As duration of
Figure 21-5. Maneuver for delivery of the head. The fingers of the left hand
are inserted into the infants mouth of over mandible; the right hand exerts
pressure on the head from above. (Modified and reproduced, with
permission, from Benson RC:Handbook of Obstetrics & Gynecology, 8th ed.
Lange, 1983)
Mauriceau Maneuver
Piper forceps
Figure 21-12. Application of Piper forceps, employing towel sling support. The forceps are
introduced from below, left blade first. Aiming directly and intended positions on sides of
the head. (Reproduced, with permission, from Benson RC:Handbook of Obstetrics &
Gynecology, 8th ed. Lange, 1983)
Breech Extraction
C-Section Indication
A Hyperextended fetus
Uterine dysfunction
Footling presentation
COMPLICATIONS
1. Perinatal morbidity and mortality from difficult delivery