BREECH PRESENTATION

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 INTRODUCTION

A breech birth is the birth of a baby from a breech presentation, in which the baby exits the pelvis with the buttocks or feet first  as opposed to the normal head-first presentation. In breech presentation, fetal het sound are heard just above the umbilicus. in a breech presentation, the lie is longitudinal and the podalic pole presents at the pelvic brim.


DEFINITION OF BREECH PRESENTATION-

IN breech presentation , the fetus lies longitudinally with the buttocks in the lower pole of the uterus. The presenting diameter is bitrochanteric 10 cm and the denominator is sacrum.

TYPES OF BREECH PRESENTATION

There are two types of breech presentation-


1. Complete BREECH or FLEXED breech
The fetus is in normal attitude of full flexion. The thighs are flexed at the hips and the legs are flexed at knees. The presenting part consists of two buttocks, external genitalia and two feet. It is commonly present in multipara.


2. Incomplete Breech
This is due to varying degrees of extension of things or legs at the podalic pole. There are three varieties in this.


  CAUSES OF BREECH PRESENTATION

No definite cause in identified, but the following circumstances favour breech presentation:
-PREMATURITY: This is the commonest cause,
-EXTENDED LEGS: Spontaneous cephalic version may be prevented if the fetus lies with extended  legs, splinting the back.
-MULTIPLE PREGNANCY: This limits the space available for each fetus to turn and thus one or both fetuses may present by breech.
-POLYHYDRAMNIOS OR OLIGOHYDRAMNIOS: Distension of the uterine cavity by excessive fluid or inadequate fluid may cause this.
-HYDROCEPHALY: The increased size of the fetal head is accommodated in the fundus.
-Uterine abnormalities such as septate uterus and accommodated in the fundus.
-Placenta praevia.
-Pelvic tumors.
-Multiparity.
-Cornual implantation of the placenta.






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