The breech position is the fetal position with the breech as the revealing part. It is the most common kind of abnormal fetal position. By the third trimester of pregnancy, it accounts for about 3% to 4% of the total number of deliveries. Depending on the position of the indicator point, it can be divided into left sacral anterior (LSA), sacral right anterior (RSA), sacral left transverse (LST), sacral right transverse (RST), sacral left posterior (LSP), and sacral posterior right (RSP). Clinically, it can be divided into single breech position or straight leg breech position, complete breech position or mixed breech position, and incomplete breech position or foot position.
The reasons are related to the abnormal pelvis, abnormal uterine morphology, placenta previa blocking the acceptance of fetal title, etc.
The fetal position should be corrected at 28 to 32 weeks of pregnancy. Appropriate auxiliary methods can be used during delivery, such as breech assisted delivery, breech traction, etc.; for those with pelvic stenosis and the estimated fetus is above 3500g, cesarean section is feasible.
During childbirth, complications such as premature rupture of membranes, premature delivery, umbilical cord prolapse, neonatal intracranial hemorrhage, neonatal asphyxia, neonatal birth injury, and soft birth canal injury can occur in the breech position. Therefore, breech delivery tends to choose cesarean delivery, and the rate of breech cesarean delivery for primipara has reached 60%. When the breech position is delivered through the vagina, the newborn should be prepared to rescue the newborn. The vulva should be disinfected when the uterine opening is 4 to 5 cm wide. Whenever the uterine contraction, the vagina should be blocked with the palm with a sterile towel to lower the fetal buttocks. A uterine orifice is opened, and when hip delivery or hip traction is required, the fetal head should be delivered within 2 to 3 minutes after the umbilical delivery, and the longest should not exceed 8 minutes. If necessary, use forceps to assist the delivery of the posterior fetal head
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