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35 Cards in this Set
- Front
- Back
RSA
Breech Positions |
Right Sacrum Anterior
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LSA
Breech Positions |
Left Sacrum Anterior
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SA
Breech Positions |
Sacrum Anterior
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SP
Breech Positions |
sacrum posterior
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RST
Breech Positions |
Right sacrum transverse
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RSP
Breech Positions |
Right sacrum posterior
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LST
lBreech Positions |
Left Sacrum Transverse
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LSP
Breech Positions |
left sacrum posterior
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Breech
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Longitudinal lie, presenting part breech, or buttocks, denominator is sacrum
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Breech
Incidence |
3 to 4 % of pregnancies at term.
25% at 28 weeks, decreasing nearer to term. |
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Breech
Risk factors |
abdominal relaxation, high parity, multiple gestation, preterm labor, hydramnios, oligohydramnios, uterine anomalies, fetal demise, contracted pelvis, hydrocephaly, anencephaly, placenta previa
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Breech
symptoms |
rib pain, feeling movement in lower abdomen
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Breech
Signs |
fundal height higher than gestational age, head felt in fundus, breech in pelvis, no cephalic prominence is felt in pelvis, presentng part is high on vaginal exam, FHT MAY be heard above or at umbilicus, Presenting part is soft and irregular
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Breech
Complete |
Denominator sacrum,
presenting part is fetal pelvis knees and thighs abducted |
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Breech
footling |
foot presenting part
single or double, extension at knees and thighs |
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Breech
Frank |
Denominator sacrum
presenting part fetal pelvis thighs abducted knees extended 66% of breeches are frank |
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Breech
Kneeling |
single or double, extension of thighs and flexion at knees.
Knees are presenting part |
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Breech
Test |
U/S to confirm diagnosis, discover fetal anomalies, measure biparietal diameter, localize placenta, R/O previa
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Breech
Complementary Medicine |
Slant board, visualization, acupuncture,
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Breech
External Cephalic version Standard of Practice |
External version done in presence of U/S to check for fetal position, EFM.
use of medications to diminish contractions, in some hospitals with IV and capability of C-section |
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Breech
External version Midwifery Practice |
local laws rule
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Breech
Mechanisms of Labor |
descent: buttocks and lower limbs, shoulders and arms, finally head
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Breech
risk to baby |
asphyxia, cord prolapse, seizure, coma, death, aspiration of amniotic fluid, fractures, skull fractures, cervical and brachial plexus paralysis, spinal cord injury, liver and internal organ injury
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Breech
risk for mother |
lacerations, and hemorrhage from rapid birth of the head
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Breech
Vaginal exam labor |
presenting part high, presenting part may be soft and irregular, sometimes foot or knee is felt
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Breech
Abdominal exam |
hard head felt in fundus, soft breech felt in lower abdomen, no cephalic prominence found in pelvis. FHTs may be at or above umbilicus.
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Breech
Oxorn Trial of labor |
36 to 42 weeks gestation
2500 to 3800g Frank Breech Biparietal <9.5cm not fetal need for c=section breech score of 4 or > |
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Breech score
oxorn |
includes, parity, gestational age, previous breech >2500, cervical dilatation, station
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Breech
Trial of Labor oxorn |
Bedrest
continuous monitoring, minimize vag exams leave membranes intact until labor is well advanced. |
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Breech Trial of labor
oxorn card 2 |
vag exam at SROM to R/O cord prolapse
IV of saline |
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Breech
second stage oxorn spontatneus/assisted |
Lithotomy (or not as extreme supine)
Monitor FHTs no interference or handling of the baby until the birth of the body until the umbliicus, hard bearing down efforts by mother suprapubic pressure to ensure flexion of hte head |
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Breech
Midwifery Model of Care Spontaneous |
1 complete dilation with frank breech
2 supine or upright position 3baby born to umbilicus, cord looped down, weight of baby causes traction to head holding it in flexion 4 arms are swept down 5 bear down hard, following the instruction of the midwife 6 as back of neck is visualized, legs are raised, to maintain flexion 7 mentum delivered,face the occiput Do Not allow the Baby to restitute to Mentum anterior |
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Breech
Midwifery Model of Care Preperation |
patient instructed to follow midwives instruction exactly
preparation for resuscitation made Preparation for transport made Draw up Pitocin prepare material for suturing |
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Unexpected Breech
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Remain calm
Call 911 If delivery is eminent prepare to resuscitate baby, Calmly describe the situation to the family. If there is time discuss transport and possible c-section, and experience |
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Breech
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place fingers inside vagina, find mentum,
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