External Cephalic Version: Pregnancy
Written by Dr.ChrisExternal cephalic version: The object of this procedure is to substitute a vertex for a less favourable presentation.
Indication: The common indication for external cephalic version is a breech or shoulder presentation diagnosed in the last weeks of pregnancy. Before resorting to this procedure it is necessary to make sure that 1) the abdominal waIl is […]
Tags: antepartuni hemorrhage, Antibiotic, breech, Delivery, ECLAMPSIA, Gonorrhoea, Infection, malpresentations, PRE-ECLAMPSIA, Pregnancy, Pubis, Uterus
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Course of labour in oblique lie
Written by D C MorganCourse of labour:
The oblique lie presents enormous difficulties to the delivery of the fetus. In fact, with a normal pelvis and a normally developed fetus at term presenting by the shoulder, spontaneous termi-nation of labour is impossible without serious risks to the mother and child. There are a few exceptional ways in which an oblique […]
Tags: breech, Clavicle, Scapula
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Transverse or Oblique Lie
Written by D C MorganIn a transverse or an oblique lie, the fetus lies generally with the cephalic pole in one or other of the iliac fossae and the breech at the opposite end of an oblique diameter of the uterine ovoid. A true transverse lie, as such, does not occur in most instances, as the natural tendency is […]
Tags: breech, Clavicle, Scapula
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Fetal injuries in breech deliveries
Written by D C MorganFetal injuries in breech deliveries: The fetus is prone to several injuries during the course of delivery. These include fractures of long bones, the lower jaw, fracture dislocation of cervical vertebrae, intracranial hemorrhage and injury to the soft parts and nerve roots.
The extent of the injuries will depend upon the difficulties arising in the course […]
Tags: breech, caesarean
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Breech Delivery
Written by D C MorganBreech Delivery Changing Trends: Primary caesarean section is now freely employed for indications mentioned above. Sec-tion has been extended to deliver fetuses weigh¬ing less than 2,500 g. In many western institu¬tions, the section rate has increased three times for breech during the last few years. Despite the high caesarean section rate, the perinatal mortality rate […]
Tags: breech, caesarean
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Fetal mortality
Written by D C MorganFetal mortality: The gross fetal mortality in breech deliveries is high but it is mostly due to complications. In uncompli¬cated breech deliveries, with skilled assistance and judicious employment of caesarean section, the perinantal mortality is in the region of 5-6 per cent. Of late, there has been a great increase in the incidence of caesarean […]
Tags: breech, caesarean
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Place of Caesarean Section
Written by D C MorganThe place of caesarean section: There has been a considerable increase in the incidence of caesarean section in breech deliveries which has somewhat improved the fetal prognosis. We propose to discuss only the indications for caesarean section for a primary breech presentation, that is, where there are no other etiological factors like contracted pelvis, which […]
Tags: breech, caesarean
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Pregnancy: Uterine inertia
Written by D C MorganUterine inertia: This is a common complication in breech delivery. Under the influence of seda¬tives and given enough time, the uterine action is often restored to normal and the labour proceeds.
Sometimes the inertia persists. If it is associated with a large baby or a contracted pelvis and an average sized fetus, if inertia supervenes […]
Tags: BPD, breech
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Extended Breech
Written by D C MorganExtended breech: This should not really be consi¬dered as a complication of breech presentation. In fact, of all varieties of podalic presentations, it has the best fetal prognosis. Owing to the com¬pactness of the presenting part, it engages early in labour in the absence of any contractions of the pelvis or feto-pelvic disproportion. Uterine inertia, […]
Tags: BPD, breech
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Method of delivery of the breech
Written by D C MorganWith increasing uterine contractions, the breech emerges out of the vulval outlet. With a fully flexed breech, sometimes a foot may be caught in the vagina which should be released by hooking it out with the finger. With further contractions and straining by the patient the baby is born as far as the umbilicus. At […]
Tags: BPD, breech
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Precautions necessary during external version
Written by D C MorganPrecautions necessary during external version: Vaginal delivery: Once vaginal delivery is All movements must be gentle. The flexion decided upon, there are three methods usually attitude of the fetus must be maintained. Anes¬ adopted:
thesia is best avoided, as otherwise one may not 1. Spontaneous breech delivery
be able to gauge the degree of force used. How¬ 2. Assisted […]
Tags: BPD, breech
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Place of external cephalic version
Written by D C MorganThe place of external cephalic version: Upto the 34th week of pregnancy breech presentations are common. Many breech presentations by that period correct themselves spontaneously into vertex presentations. After the 34th week, the incidence of such spontaneous corrections drop down significantly and after the 36th week it is rather rare. Hence it is suggested that […]
Tags: BPD, breech
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Breech Presentation: Antenatal period
Written by D C MorganAntenatal period: When a breech presentation is found to persist in a primigravid woman after the 34th week of pregnancy, every attempt should be made to find out the etiological factor. In particular, the pelvis should be suspected and radiopelvimetry should be done to rule out any contraction.
If a contracted pelvis is diagnosed or any […]
Tags: BPD, breech
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Prognosis of Breech Presentation
Written by D C MorganPrognosis of Breech Presentation
Mother: The maternal morbidity is slightly higher than in vertex presentations because of the increased incidence of interference.
Child: There is no doubt that, as far as delivery is concerned, vertex presentation is the safest for the baby. The fetal mortality in breech delivery shows wide variations — from two per cent to […]
Tags: breech, symphysis pubis, vaginal examination
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Diagnosis of Breech Presentation
Written by D C MorganDiagnosis of Breech Presentation:
Abdominal palpation: On palpation, the cephalic pole will be felt at the fundus of the uterus and can be differentiated from the breech because the head is smaller, harder, and more movable and it ballots independently of the rest of the body. The umbilical grip will reveal the presence of the back […]
Tags: breech, symphysis pubis, vaginal examination
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