Obstetrics and Gynecology Board Review Pearls of Wisdom

(Elliott) #1

••• Chapter 8^ Breech^89


❍ What are some common fetal complications associated with a vaginal breech delivery?
Fracture of either the humerus or clavicle.
Skull fractures.
Paralysis of the arm.
Testicular injury.
Increased risk of sudden infant death syndrome.


❍ Name a condition when a vaginal breech delivery of a singleton should be considered.
A patient presents in active labor, with advanced cervical dilation and delivery appears.


❍ True or False: Planned cesarean section is the recommended mode of delivery for a persistent
breech presentation.
True.


❍ In the United States, the percentage of breech presentations who are delivered by u cesarean section?
90%.


❍ Required conditions to consider for external cephalic version (ECV)? (New)



  • Breech presentation.

  • Reassuring fetal heart tracing.

  • No contraindications for vaginal delivery.

  • ≥36 weeks’ gestation.


❍ What is the most favorable factor associated with successful ECV?
Parity.


❍ Factors associated with an unsuccessful version include?



  • Diminished amniotic fluid.

  • Obesity.

  • Anterior placenta.

  • Cervical dilation.

  • Descent of breech into the pelvis.

  • Positioning of the fetal spine.


❍ Name three absolute contraindications for ECV.



  • Contraindications to vaginal delivery, ie, previa.

  • Multiple gestations with a breech presenting fetus.

  • Nonreassuring fetal status.


❍ Relative contraindications for ECV include?



  • Abnormal fluid, both poly and oligohydramnios.

  • Fetal growth restriction.

  • Fetal anomaly.

Free download pdf