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Chapter 12 - Breech Presentation

from Part II - INTRAPARTUM AND POSTPARTUM

Published online by Cambridge University Press:  07 May 2010

John Patrick O'Grady ,
Martin L. Gimovsky ,
Lucy A. Bayer-Zwirello  and
Kevin Giordano
John Patrick O'Grady
Affiliation:
Tufts University, Massachusetts
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Summary

This chapter reviews the fundamentals of the techniques for breech delivery and the evaluative process required for appropriate management. Also reviewed are external cephalic version (ECV) and internal podalic version (IPV) and the special needs of the premature breech fetus at delivery. These concepts and approaches are applicable in all breech presentations, independent of the route of delivery. Techniques for delivering the breech fetus are assisted breech delivery, delivering the aftercoming head, and breech extraction. Piper forceps (or alternatively, Simpson or Keilland forceps) can be used for delivering the aftercoming head at the clinician's discretion. The risk that the breech fetus might become acidotic during labor and delivery is marginally greater than for its cephalic counterpart. Once a breech presentation has been diagnosed, the patient and her family can be counseled and instructed about the potential problems that might be encountered.

Keywords

assisted breech deliverybreech extractionbreech laborforcepspremature breech fetusinternal podalic versionbreech presentationexternal cephalic version
Type
Chapter
Information
Operative Obstetrics , pp. 297 - 321
Publisher: Cambridge University Press
Print publication year: 2008

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