Thursday, January 20, 2011

Breech Delivery

Breech Delivery

Breech babies can present in a variety of ways, including buttocks first, one leg or both legs first.

Frank breech means the buttocks are presenting and the legs are up along the fetal chest. This is the safest position for breech delivery.

Breech.jpg (56529 bytes)If either foot is presenting ("footling breech"), there are increased risks of umbilical cord prolapse and delivery of the feet through an incompletely dilated cervix, leading to arm or head entrapment.

Because of the risks of breech delivery, in many civilian hospitals most or all breech babies are born by cesarean section.

In operational settings, cesarean section may not be available or may be more dangerous than performing a vaginal breech delivery.

The simplest breech delivery is called a spontaneous breech.

The mother pushes the baby out with the normal bearing down efforts and the baby is simply supported until it is completely free of the birth canal. These babies pretty much deliver themselves.

This works best with smaller babies, mothers who have delivered in the past, and frank breech presentation.

If the breech baby gets stuck half-way out, or if there is a need to speed the delivery, an "assisted breech" delivery is performed. For this type of delivery, it is very helpful to have a second person to aid you.

A generous episiotomy will give you more room to work, but may be unnecessary if the vulva is very stretchy and compliant.

Breech1.jpg (57207 bytes)Grasp the baby so that your thumbs are over the baby's hips. Rotate the torso so the baby is face down in the birth canal.

A towel can be wrapped around the lower body to give the you a more stable grip.

Have your assistant apply suprapubic pressure to keep the fetal head flexed.

Breech2.jpg (58440 bytes)Exert gentle outward traction on the baby while rotating the baby first clockwise and then counterclockwise a few degrees to free up the arms.

If the arms are trapped in the birth canal, you may need to reach up along the side of the baby and sweep them, one at a time, across the chest and out of the vagina.

It is important to keep you hands low on the baby's hips. If you grasp the baby above the hips, it is relatively easy to cause soft tissue injury to the abdominal organs, including the kidneys.

Breech6.jpg (60885 bytes)During the delivery, always keep the baby at or below the horizontal plane or axis of the birth canal.

If you bring the baby's body above the horizontal axis, you risk injuring the baby's spine.

Only when the baby's nose and mouth are visible at the introitus is it wise to bring the body up.

The application of suprapubic pressure by the assistant is important for keeping the head flexed against the chest, expediting delivery, and reducing the risk spinal injury.

At this stage, the baby is still unable to breath and the umbilical cord is likely occluded.

Without rushing, move steadily toward a prompt delivery.

Placing your finger in the baby's mouth may help you control the delivery of the head.

Try not to let the head "pop" out of the birth canal. A slower, controlled delivery is less traumatic

Rawatan Homeopathy Untuk Bayi Songsang

Ubat-ubat homeopathy amat bagus digunakan untuk membetulkan kedudukan bayi yang songsang. Anda perlu makan ubat homeopathy sebaik sahaja anda tahu kedudukan bayi songsang. Dalam waktu yang selalu, InsyaAllah jika ubat serasi dengan anda, bayi akan kembali dalam kedudukan asal.

Selamat mencuba.

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