Spaces:
Sleeping
---\n\ncitation: "Breech"\n\n---\n\nManagement of Breech Presentation
Clinical
Clinical
• Abdominal examination: the head of the fetus is in the upper part of the uterus.
X-ray of the
pelvis to
confirm
presentation is
to be avoided.
Ultra sound
• Auscultation locates the fetal heart at a higher location than expected with a vertex presentation.
• conform the presenting part
•
localizatiion of placenta
• Vaginal examination: the buttocks and/or feet are felt. Thick, dark meconium is normal when membranes rupture in the second stage of labour.
• exclusion of
abnormalities,etc.
THE DIAGNOSIS OF BREECH CONFIRMED
— External cephalic version not acormamenaladt Wait till 36 completed wi —
: prior to 36 completed
36 weeks
uncomplicated breech at 37 to 40 weeks
uncomplicated (no extended or |] complicated (extended or flexed leg) breech presentation flexed leg) breech presentation at term at term
38 weeks
Delivery
No indication
for L.S.C.S
Relative indications for Absolute indications for Caesarean section Caesarean section Intrauterine growth restriction. Feto-pelvic disproportion Previous uterine scar -When the fetal weight is estimated to Hyperextension of the fetal head be 3.8 kg or more (Star gazer) Major degree placenta praevia -When the head cannot be flexed Pelvic or uterine tumors preventing Small pelvis or suspicious pelvic descent of presenting part. adequacy Major degrees of pelvic deformities. Footling presentation Gestation less than 34 weeks
Vaginal delivery
Sri Lanka College of Obstetrics and Gynaecology Health sector development Project Guidelines- Management of breech presentation
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