Reading...
Play button
Play button
Use LEFT and RIGHT arrow keys to navigate between flashcards;
Use UP and DOWN arrow keys to flip the card;
H to show hint;
A reads text to speech;
31 Cards in this Set
- Front
- Back
|
UNDERSTAND TYPES OF BREECH PRESENTATIONS
UNDERSTAND DELIVERY OPTIONS , RISKS & BENEFITS DELIVERY TECHNIQUES EXTERNAL VERSION |
LEARNING OBJECTIVES
|
|
|
BREECH PRESENTATION ONLY ACCOUNTS FOR ___% OF SINGLETON DELIVERIES
|
3-4
|
|
|
Babies are born 2 ways; breech or _____
|
vertex
|
|
|
ETIOLOGY of breech INCLUDES HYD-_____, MULTIPLE FETUS, RELAXED UTERUS, PLACENTAL & UTERINE ABNORMALITIES , FETAL MALFORMATIONS
|
HYDRAMNIOS
|
|
|
COMPLICATIONS COMMONLY FOUND IN ASSOCIATION WITH PERSISTANT BREECH PRESENTAION;
|
1. morbidity and mortality
2. low birthweight, growth restriction 3. prolapsed cord 4. placenta previa 5. fetal, neonatal, and infant anomalies 6. uterine anomalies and tumors |
|
|
TYPES OF BREECH PRESENTATIONS
|
COMPLETE-
FRANK BREECH- FOOTLING BREECH- |
|
|
Describe COMPLETE breech
|
1 OR BOTH KNEES FLEXED
|
|
|
Describe FRANK BREECH-
|
HIPS FLEXED & KNEES EXTENDED
|
|
|
Describe FOOTLING BREECH-
|
1 OR BOTH FEET PRESENTING
(most distressing) |
|
|
How do you make the DIAGNOSIS of breech? –
|
ABDOMINAL EXAM CAN PROVIDE DX
LOCATION OF FETAL HEART TONES ABOVE THE UMBILICUS ULTRASOUND USED IF DX UNCERTAIN |
|
|
BOTH MOTHER & FETUS AT GREATER RISK WITH BREECH PRESENTATION COMPARED TO _____
|
CEPHALIC
|
|
|
MATERNAL MORBIDITY & MORTALITY RELATED TO HIGHER INCIDENCE OF ________
|
OPERATIVE DELIVERY
|
|
|
MAJOR CONTRIBUTORS TO PERINATAL LOSS ARE ; PRETERM DELIVERY,CONGENITAL ANOMALIES & _________
|
BIRTH TRAUMA
|
|
|
LIBERAL USE OF _______ HAS HELPED REDUCE MORTALITY, AVOIDING LABOR AUGMENTATION & HAVING EXPERIENCED OB AT BIRTH WILL ALSO HELP
|
C-SECTION
|
|
|
DELIVERY OF THE BREECH BRINGS THE UMBILICUS AND CORD INTO THE PELVIS WHICH does what to the cord?
|
COMPRESSES THE CORD
|
|
|
Why is there more rik with breech PRETERM FETUS ?
|
DISPARITY BETWEEN HEAD & BUTOCK IS EVEN GREATER
|
|
|
TO AID IN DELIVERY OF HEAD INCISCIONS ARE SOMETIMES MADE IN THE _______ TO RELEASE THE HEAD
|
CERVIX
|
|
|
FREQUENCY OF CORD PROLAPSE IS ALSO INCREASED WHEN FETUS IS SMALL , HIGHEST WITH ______ BREECH
|
FOOTLING
|
|
|
BECAUSE THERE IS NO TIME FOR ______________, A PELVIS THAT WAS OK FOR VERTEX PRESENTATION CAN CAUSE SERIOUS PROBLEMS FOR A BREECH
|
MOLDING OF THE FETAL HEAD
|
|
|
HYPER-________ OF FETAL HEAD WITH VAGINAL BREECH MAY CAUSE SEVERE SPINAL CORD DAMAGE & SHOULD BE C/S
|
HYPEREXTENSION
|
|
|
LABOR INDUCTION & AUGMENTATION FOR BREECH – MATTER OF CONSIDERABLE CONTROVERSY. Do it?
|
no
|
|
|
THE AFTERCOMING HEAD CAN EASILY BECOME ENTRAPPED BY AN INCOMPLETELY DILATED ____
|
CERVIX
|
|
|
THE AMERICAN COLLEGE OF OB/GYN RECC. ________PERSISTANT BREECH PRESENTATION EXCEPT WHEN BIRTH IS IMMINENT
|
PLANNED C-SECTON FOR
|
|
|
3 METHODS OF VAGINAL DELIVERY
|
SPONTANEOUS
PARTIAL BREECH EXTRACTION- TOTAL BREECH EXTRACTION- |
|
|
Describe SPONTANEOUS –
|
NO TRACTION OR MANUEVERING BY OPERATOR
|
|
|
Describe PARTIAL BREECH EXTRACTION-
|
SPONT. DELIVERY TO UMBILICUS, REST DELIVERED BY OPERATOR
|
|
|
Describe TOTAL BREECH EXTRACTION
|
- ENTIRE BODY OF INFANT EXTRACTED BY OB
unfold legs one at a time pull legs out rotate baby around use "piper"(?) forceps |
|
|
COMPLICATIONS of breech delivery
|
ANOXIA DUE TO CORD COMPRESSION
BIRTH INJURY- 13 TIMES THAT OF CEPHALIC PRESENTATION ENTRAPMENT OF HEAD BY PARTIAL CERVICAL DILATION NUCHAL ARMS – ARMS BECOME ENTRAPED BEHIND THE NECK |
|
|
FEW INJURIES IN SPONT. BREECH, 6% IN PARTIAL EXT., ___% IN TOTAL EXT.
|
20
|
|
|
EXTERNAL CEPHALIC ______ MAY BE DONE AFTER 36 WKS., IF PROBLEMS OCCUR , DELIVERY CAN BE DONE IMMEDIALTELY
|
VERSION
|
|
|
EXTERNAL CEPHALIC VERSION
DONE WITH SONO GUIDANCE & WITH TOCOLYTICS SUCCESS rate is what? |
~60%
|
