TAILIEUCHUNG - Ebook Clinics in obstetrics: Part 2

Part 2 book “Clinics in obstetrics” has contents: Breech presentation, cardiac disease in pregnancy, pyrexia in pregnancy, postpartum hemorrhage, convulsions in pregnancy, RH negative pregnancy, thyroid disorders in pregnancy, jaundice in pregnancy, and other contents. | CHAPTER 12 Breech Presentation Tania G Singh DEFINITION • Defined as a fetus in a longitudinal lie with the buttocks or feet closest to the cervix (at the maternal pelvic outlet) • Commonest of all the malpresentations. INCIDENCE • • • • • • 3–4% of all deliveries Decreases with advancing gestational age: – 22–25% of births prior to 28 weeks gestation – 7% of births at 32 weeks gestation – 1–3% of births at term Fetal abnormalities are observed in: – 17% of preterm breech deliveries – 9% of term breech deliveries Cord prolapse occurs in: – 0–2% with frank breech – 5–10% with complete breech – 10–25% with footling breech – 6% in multigravidas – 3% in primigravidas Nuchal arms (one or both arms are wrapped around the back of the neck) are present in: – 0–5% of vaginal breech deliveries – 9% of breech extractions Fetal head entrapment (results from an incompletely dilated cervix and head that lacks time to mold to the maternal pelvis): – 0– of vaginal breech deliveries • Perinatal mortality: – Increased 2–4 fold with breech presentation, regardless of mode of delivery – Commonest causes: - Malformations - Prematurity - Intrauterine demise. 404 Section 1: Long Cases PREDISPOSING FACTORS • • • • • • • • • • • • • Prematurity (most common cause) Uterine malformations (septate; bicornuate uterus) Fibroids and cysts Polyhydramnios Oligohydramnios Placenta previa Cornual or fundal placement of placenta Fetal abnormalities (. CNS malformations—anencephaly, Down’s syndrome, hydrocephalus; myotonic dystrophy, neck masses, heart and GIT disorders) Multiple gestation Multiparity Breech presentation in the previous pregnancy Stretched and weakened uterine muscle Short umbilical cord. TYPES OF BREECHES • Frank or extended breech (50–70%)—Hips flexed, knees extended (pike position). Least associated with cord prolapse. Good dilator of the cervix • Flexed or complete breech (5–10%)—Hips flexed, knees flexed (cannon

• Y khoa - Dược
• Clinics in obstetrics
• Antenatal care
• Postpartum hemorrhage
• Convulsions in pregnancy
• RH negative pregnancy
• Thyroid disorders in pregnancy
• Jaundice in pregnancy
• Recurrent pregnancy loss
• Antepartum hemorrhage in early pregnancy
• Uterine size more than expected
• Uterine size less than expected
• BMC Cancer
• High risk Human Papillomavirus
• Cervical cytology
• Obstetrics and gynecology
• Genotype distribution
• Real time PCR
• Pap cytology
• Uterine Leiomyomata
• Genetic Heterogeneity
• Borderline Smooth
• Muscle Tumors
• Clinical Features
• Diagnostic Imaging
• Endocrinology of lactation
• Biochemical screening
• human pregnancy
• Hormonal monitoring
• Hormonal regulation
• Strengthening Gynecologic
• Cancer Prevention
• Ovarian Cancer
• Prophylactic Human
• Endometrial Hyperplasia
• Environmental Health
• CARDIOVASCULAR
• Heart Murmurs
• Allergic Rhinitis
• INFECTIOUS DISEASE
• NEUROLOGIC
• Vascular Birthmarks
• Vascular Malformations
• Syndromes Associated
• patterned dyspigmentation
• Melanocytic Nevi
• Kaposiform Hemangioendothelioma
• Abdominal Pain
• Gastrointestinal Bleeding
• Bowel Disease
• Bleeding Disorders
• Multiple Myeloma
• Pain Management
• leukemia
• lymphoma
• Hepatic Cancer
• Trophoblastic Diseases
• Human Chorionic
• Patient Safety
• Gynecology Office
• Pulmonary Medicine
• Internal Medicine
• Palliative Care
• Obstetric Med
• Musculoskeletal Diseases
• Infectious Diseases
• Pulmonary Diseases
• Vascular Diseases
• Critical Care
• Alternative Medicine
• MUSCULOSKELETAL
• Alcohol Withdrawal
• Hospitalized Patient
• Oncologic Emergencies
• Chest Physicians
• Peripartum Management
• Perioperative Management
• Anticoagulated Patient
• Venous Thromboembolism
• Acquired Thrombophilia