After coming head of breech will have difficulty in delivery in all of the following conditions except :
Correct Answer: Placenta pre
Description: Ans. is b i.e. Placenta pre Entrapment of the after coming head occurs in case of: Incompletely dilated cervix Hydrocephalus Extended head I deflexed head Contracted pelvis Management : If entrapment occurs due to incompletely dialated cervix Vuhrssen's incisions' are placed over the cervix avoiding the 3 and 9'0 clock position. Intravenous nitroglycerine can be used to relax the cervix. Replacement of the fetus higher in to the vagina and uterus, followed by cesarean delivery (Zavanelli maneouvre) Symphysiotomy used to widen the anterior pelvis is practiced in some countries and is associated with good infant outcomes. Also Know Impacted Breech Inspite of good uterine contractions and complete dilatation of the cervix, the breech fails to descend. This occurs only in extended breech and is usually due to dispropoion. Impaction can occur at the inlet, cavity or outlet. If within 30 min of full cervical dilatation the breech does not descend and distend the perineum, cesarean section is done regardless of the level of impaction.
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Gynaecology & Obstetrics
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