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Breech Delivery
Aka: Breech Delivery
- Epidemiology
- BreechVaginal Delivery is uncommon in United States
- In U.S., 90% of Breeches are delivered by ceserean
- Indications
- Complete or Full Breech Presentation
- Estimated fetal weight between 2 to 4 kg
- Expert physician
- Contraindications
- Unfavorable Pelvis (e.g. android, platypelloid, small)
- Fetal Macrosomia (3800 grams)
- Suspected utero-placental insufficiency
- Intrauterine Growth Retardation
- Footling Breech
- Fetal Hydrocephalus
- Inexperienced clinician
- Hyperextension of fetal head
- Severe prematurity
- Technique
- Large episiotomy
- Piper forceps
- Complications of Breech Delivery: Maternal
- Placental Abruption
- Fourth degree perineal tear
- Complications of Breech Delivery: Fetus
- Intracranial Hemorrhage due to rapid molding
- Ruptured tentorium cerebelli
- Ruptured falx cerebri
- Neck Trauma due to traction
- Dislocation of neck
- Erb-Duchenne Paralysis
- Torticollis from Sternocleidomastoid muscle trauma
- Ruptured viscus (Kidney or liver)
- Secondary to abdominal pressure from grasp
- Genital edema due to caput formation
- Shoulder and arm trauma on delivery of arms
- Shoulder Dislocation
- Clavicle Fracture
- HumerusFracture
- Cord prolapse (more common in Footling Breech)
- Hip and leg trauma from traction
- Hip Dislocation
- FemurFracture
- Knee Joint disruption