All the following can be a cause for obstruction of after coming head of breech Except:
Correct Answer: Placenta previa
Description: Ans. b. (Placenta previa). (Ref. Dutta Obstetrics 5th ed. 402)BREECH PRESENTATION# Most common type is complete breech in multipara and frank breech (70%) in primi.# Prematurity is the commonest cause.# Other causes are uterine malformations (recurrent breech) and hydrocephalus.# Denominator--sacrum# Commonest positions--left sacroanterior# Perinatal mortality rate is 3-10% in uncomplicated breech.# Foetal mortality is least in frank breech and maximum in footling presentation.# Gynaecoid and anthropoid pelvis are favourable for after coming head of breech.# After coming head of breech is an indication for external cephalic versionThere is no consensus that after coming head of breech can be obstructed by placenta previa.PLACENTA PREVIA# Placenta implanted wholly or partially in the lower uterine segment. 28% of women scanned before 24 weeks gestation have a low lying placenta - 3% at term.# Trans-vaginal scanning improves accuracy of diagnosis of placenta previa especially with posterior placenta.- If the placenta encroaches or covers the internal cervical os then there is MAJOR placenta previa otherwise there is MINOR placenta previa. This has replaced grades I - IV.# Risk factors- Increasing maternal age / smoking / previous caesarean section / previous placenta previa - 4-8% recurrence risk# Maternal risks- Haemorrhage related mortality- PPH- Complications of caesarean section post-partum sepsis- Placenta accreta (up to 15% of placenta previa)Recurrence risk# Fetal risks- Prematurity- IUGR- Congenital malformations (double risk of serious malformation)- Mal-presentation.
Category:
Gynaecology & Obstetrics
Get More
Subject Mock Tests
Practice with over 200,000 questions from various medical subjects and improve your knowledge.
Attempt a mock test nowMock Exam
Take an exam with 100 random questions selected from all subjects to test your knowledge.
Coming SoonGet More
Subject Mock Tests
Try practicing mock tests with over 200,000 questions from various medical subjects.
Attempt a mock test now