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Breech
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Types
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RF
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· Advanced maternal age (>35)
· Multi-parity
· Uterine didelphys, septate uterus
· Uterine leiomyomas
· Fetal anomalies (eg, anencephaly)
· Preterm (<37 weeks gestation)
· Oligohydramnios/ polyhydramnios
· Placenta previa
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Dx
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Vaginal PEx → US
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Tx
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· External cephalic version AFTER 36 weeks
· If not successful –> CS
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External Cephalic Version Procedure
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Definition
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A procedure to change the baby position from breech to vertex presentation
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?
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When to do it?
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· at 37 weeks to ⤵️ the risk of preterm delivery
· If it failed, go to CS.
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Contraindications
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· Any contraindication to vaginal delivery (placenta previa, vasa previa, active genital herpes outbreak, and prior classical CS),
· Multiple Gestations
· Abnormal uterus (bicornucate, etc)
· PIH
· Relative contraindications: oligo/polyhydroamnios / IUGR
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Fast HY Review 