COMPLICATIONS OF PERSISENT BREECH PRESENTATION  Prolapsed cord  Placenta previa  Congenital anomalies  Uterine anomalies and tumors  Difficult delivery  Increased maternal and perinatal morbidity .

but not exclusively.Common reasons for Cesarean delivery: is commonly. used in the following circumstances:  A large fetus  Any degree of contraction or unfavorable shape of the pelvis determined clinically or with CT pelvimetry  A hyperextended head  When delivery is indicated in the absence of spontaneous labor  Uterine dysfunction—some would use oxytocin augmentation  Incomplete or footling breech presentation .

 An apparently healthy and viable preterm fetus with the mother in either active labor or in whom delivery is indicated  Severe fetal-growth restriction  Previous perinatal death or children suffering from birth trauma  A request for sterilization  Lack of an experienced operator. .

Partial breech extraction 3. Total breech extraction .1. Spontaneous breech delivery 2.

. An obstetrician skilled in the art of breech extraction  An associate to assist with the delivery  Anesthesia personnel who can ensure adequate analgesia or anesthesia when needed  An individual trained newborn resuscitation.

Frank breech decomposition using the Pinard maneuver .

Mauriceau Maneauver .

Modified Prague Maneuver .

Piper forceps 2.1. Laufe forceps .

Duhrssen incision 2.1. Symphysiotomy . Zavanelli maneuver 3.

ruptured uterus  3. 1. extension of the episiotomy & deep perineal tears  5. anesthesia may cause uterine atony & postpartum hemorrhage . increase risk of infection  2. laceration of the cervix  4.

Separation of the epiphysis of the scapula. Fracture of the humerus & clavicle 2. Testicular injury .1. Fracture of the femur  may be associated w/ both vaginal & cesarean deliveries 3. Neonatal perineal tears 4. 6. Paralysis of the arm secondary to brachial plexus injury . Hematomas of the sternocleidomastoid muscle 5. humerus or femur. 7. Skull fractures 8.

1. should be considered at 36 wks prior to labor Contraindications:  Placenta previa  Non-reassuring fetal status  Prior uterine incision . External cephalic version  average success rate 60-65%  when a breech presentation is recognized prior to labor.

 Used for the delivery of the second twin .

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