src/processed_markdown/Breech/Breech.md

---\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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