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25 - Psychiatric emergencies
from Section 5 - Medical and Surgical Emergencies during Pregnancy
- By Andrew Kent, Lorraine Cleghorn
Edited by Edwin Chandraharan, Sabaratnam Arulkumaran
Book:

Obstetric and Intrapartum Emergencies

Published online:

05 November 2012

Print publication:

11 October 2012, pp 170-175
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Summary

This chapter discusses the types, implications and management strategies of breech delivery. Breech presentation at time of delivery is associated with increased perinatal mortality and morbidity. Any factor that affects the uterine shape and tone, passenger (fetal size, maturity, structure and number) and passage (both bony pelvis and sot tissues) can predispose to breech presentation. Before allowing vaginal breech delivery it is important to confirm the presenting part by performing a vaginal examination. An episiotomy may be performed as a prophylactic measure when the breech delivery is imminent, even in multiparous women. It has been advocated to prevent possibility of soft tissue dystocia. For simplicity, conduct of assisted vaginal breech delivery will be considered in three parts: Delivery of the legs and buttocks; Delivery of the trunk and shoulders and Delivery of the 'after-coming' head.