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Breech Delivery

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181. Cesarean Delivery

after cesarean delivery (VBAC). Indications Although morbidity and mortality rates of cesarean delivery are low, they are still several times higher than those of vaginal delivery; thus, cesarean delivery should be done only when it is safer for the woman or fetus than vaginal delivery. The most common specific indications for cesarean delivery are Previous cesarean delivery (particularly breech presentation) A nonreassuring fetal heart rate pattern, which requires rapid delivery Many women (...) Cesarean Delivery Cesarean Delivery - Gynecology and Obstetrics - MSD Manual Professional Edition Brought to you by The trusted provider of medical information since 1899 SEARCH SEARCH MEDICAL TOPICS Common Health Topics Resources QUIZZES & CASES Quizzes Cases The trusted provider of medical information since 1899 SEARCH SEARCH MEDICAL TOPICS Common Health Topics Resources QUIZZES & CASES Quizzes Cases / / / / IN THIS TOPIC OTHER TOPICS IN THIS CHAPTER Test your knowledge Vaginal Bleeding Which

2013 Merck Manual (19th Edition)

182. Operative Vaginal Delivery

to Deliver a Baby in Breech Presentation SOCIAL MEDIA Add to Any Platform Loading , MD, The Center for Fetal Diagnosis and Treatment, Children's Hospital of Philadelphia Click here for Patient Education NOTE: This is the Professional Version. CONSUMERS: Operative vaginal delivery involves application of forceps or a vacuum extractor to the fetal head to assist during the 2nd stage of labor and facilitate delivery. Indications for forceps delivery and vacuum extraction are essentially the same: Prolonged (...) Operative Vaginal Delivery Operative Vaginal Delivery - Gynecology and Obstetrics - MSD Manual Professional Edition Brought to you by The trusted provider of medical information since 1899 SEARCH SEARCH MEDICAL TOPICS Common Health Topics Resources QUIZZES & CASES Quizzes Cases The trusted provider of medical information since 1899 SEARCH SEARCH MEDICAL TOPICS Common Health Topics Resources QUIZZES & CASES Quizzes Cases / / / / IN THIS TOPIC OTHER TOPICS IN THIS CHAPTER Test your knowledge

2013 Merck Manual (19th Edition)

183. Twin and triplet pregnancy

Determining gestational age and chorionicity 7 1.2 General care 8 1.3 Delivery of antenatal and intrapartum care 9 1.4 Fetal complications 12 1.5 Preventing preterm birth 19 1.6 Maternal complications 20 1.7 Indications for referral to a tertiary level fetal medicine centre 21 1.8 Planning birth: information and support 21 1.9 Timing of birth 22 1.10 Mode of birth 24 1.11 Fetal monitoring during labour in twin pregnancy 26 1.12 Analgesia 29 1.13 Managing the third stage of labour 30 T erms used (...) pregnancy compared with women with a singleton pregnancy. [2011] [2011] 1.2.4 Perform a full blood count at 20 to 24 weeks to identify women with a twin or triplet pregnancy who need early supplementation with iron or folic acid (this is in addition to the test for anaemia at the routine booking appointment recommended in NICE's guideline on antenatal care for uncomplicated pregnancies). Repeat at 28 weeks as in routine antenatal care. [2011] [2011] 1.3 Delivery of antenatal and intrapartum care

2019 National Institute for Health and Clinical Excellence - Clinical Guidelines

184. Intrapartum care for women with existing medical conditions or obstetric complications and their babies

1.4 Asthma 20 1.5 Long-term systemic steroids 20 1.6 Bleeding disorders 21 1.7 Subarachnoid haemorrhage or arteriovenous malformation of the brain 25 1.8 Acute kidney injury or chronic kidney disease 27 1.9 Obesity 30 1.10 Information for women with obstetric complications or no antenatal care 32 1.11 Risk assessment for women with obstetric complications or no antenatal care 33 1.12 Pyrexia 36 1.13 Sepsis 36 1.14 Intrapartum haemorrhage 42 1.15 Breech presenting in labour 45 1.16 Small (...) monitoring for women in labour with sepsis or suspected sepsis 84 Antimicrobial treatment for women in labour with sepsis or suspected sepsis 85 Care for women with sepsis or suspected sepsis immediately after the birth 86 Intrapartum haemorrhage 86 Breech presenting in labour 87 Small-for-gestational-age baby 89 Large-for-gestational-age baby 89 No antenatal care 90 Previous caesarean section 91 Labour after 42 weeks of pregnancy 93 Context 94 Finding more information and resources 95 Update information

2019 National Institute for Health and Clinical Excellence - Clinical Guidelines

185. The relationship between mode of delivery and developmental dysplasia of the hip in breech infants: A FOUR-YEAR PROSPECTIVE COHORT STUDY. Full Text available with Trip Pro

The relationship between mode of delivery and developmental dysplasia of the hip in breech infants: A FOUR-YEAR PROSPECTIVE COHORT STUDY. This prospective cohort study aimed to investigate the relationship between developmental dysplasia of the hip and mode of delivery in 571 consecutive breech infants using a modified Graf's static morphological method to grade the severity of dysplasia. In this group, 262 infants were born by planned Caesarian section, 223 by emergency section and 86 (...) vaginally. Taking all grades of hip dysplasia into account (Graf types II, III and IV), there was no statistical difference in the incidence of dysplasia between the groups (elective section 8.4%, emergency section 8.1% and vaginal delivery 7.0%). However, when cases with Graf type II dysplasia, which may represent physiological immaturity, were excluded, the rate of type III and IV hips, which we consider to be clinically relevant, increased in the vaginally delivered group (4.7%) compared

2010 The Journal of Bone and Joint Surgery British Volume

186. Updated advice regarding PPE to be worn when managing pregnant women with known or suspected COVID-19

Theatre Caesarean section with neuraxial anaesthesia 1 (low risk of GA, e.g. elective CS for breech) Apron, sterile 2 FRDG, sterile gloves, FRSM, eye protection Caesarean section with neuraxial anaesthesia (but higher risk of GA 3 e.g. Category 1 CS) Apron, sterile FRDG, sterile gloves, FRSM or FFP3, eye protection Caesarean section with general anaesthesia Apron, FRDG, gloves, FFP3, eye protection Non-CS obstetric theatre cases Trial of instrumental delivery in theatre, removal of retained placenta (...) on theatre hat, FRSM & eye protection • Scrub up • Put on disposable fluid resistant sterile gown, sterile gloves • Perform epidural procedure and ensure epidural is working Prior to exit of room: • Remove gloves, clean hands with gel • Remove gown & turn inside out • Remove eye protection. • Dispose of all items in clinical waste bin • Gel hands Outside room: • Remove FRSM (avoid touching outside) & hat • Dispose of in clinical waste bin • Wash hands with soap and water Caesarean delivery spinal

2020 ICM Anaesthesia COVID-19

187. Assisted Vaginal Birth

: Correspondence: Royal College of Obstetricians and Gynaecologists, 10–18 Union Street, London SE1 1SZ. Email: on behalf of Corresponding Author E-mail address: Correspondence: Royal College of Obstetricians and Gynaecologists, 10–18 Union Street, London SE1 1SZ. Email: First published: 28 April 2020 This is the fourth edition of this guideline, first published in October 2000 under the title Instrumental vaginal delivery , and revised in January 2011 and October 2005 under the title Operative Vaginal (...) Delivery. Give access Share full-text access Please review our and check box below to share full-text version of article. I have read and accept the Wiley Online Library Terms and Conditions of Use Shareable Link Use the link below to share a full-text version of this article with your friends and colleagues. Copy URL Share a link Share on ). Grade of recommendation: D Does ultrasound have a role in assessment prior to assisted vaginal birth? Ultrasound assessment of the fetal head position prior

2020 Royal College of Obstetricians and Gynaecologists

188. Towards integrated antenatal care for low-risk pregnancy

Recommendations 82 4 Towards integrated antenatal care for low-risk pregnancy KCE Report 326 LIST OF FIGURES Figure 1 – Evolution of the average length of stay (in days) for deliveries with a low level of severity (SOI 1) in Belgium (2 nd semester 2013 - 2 nd semester 2017 [last data available]) 14 Figure 2 – Proportion of low-risk pregnant women who attended at least one consultation during their pregnancy by healthcare professional, in 2016 19 Figure 3 – Number of ANC consultations (2016) for clinical (...) on birth preparation, and more specifically on pain relief during the delivery by other means than drug-induced sedation or general anaesthesia. In 2002, WHO highlighted the need to extend birth preparation to birth and parenthood education. 2 To help the pregnant woman and her partner in the transition to parenthood, education and information programmes have been developed assuming that increased knowledge will have a positive impact on parental stress, parenting behaviours, parent-child relationship

2020 Belgian Health Care Knowledge Centre

189. The timing of elective caesarean delivery between 2000 and 2009 in England. Full Text available with Trip Pro

with autoregressive integrated moving average (ARIMA).There were 118,456 elective CS deliveries at the 63 NHS trusts. The overall proportion of elective CS deliveries done after 39 completed weeks steadily increased from 39% in 2000/01 to 63% in 2008/09. The proportions rose from 43% to 67% for women with breech presentation and from 35% to 62% for women with a previous CS. There was significant variation across NHS trusts in each year; in 2008/09, with the proportions of elective CS done after 39 weeks ranging (...) The timing of elective caesarean delivery between 2000 and 2009 in England. In 2004, the National Institute for Clinical Excellence (NICE) recommended that an elective caesarean section for an uncomplicated pregnancy should not be carried out before 39 completed weeks due to increased risk of respiratory morbidity in newborns. We describe the trends and variation across 63 English NHS trusts in the timing of elective caesarean section (CS) for low-risk singleton deliveries.We identified

2011 BMC Pregnancy and Childbirth

190. Trends in cesarean delivery for twin births in the United States: 1995-2008. Full Text available with Trip Pro

Trends in cesarean delivery for twin births in the United States: 1995-2008. To estimate trends and risk factors for cesarean delivery for twins in the United States.This was a cross-sectional study in which we calculated cesarean delivery rates for twins from 1995 to 2008 using National Center for Health Statistics data. We compared cesarean delivery rates by year and for vertex compared with breech presentation. The order of presentation for a given twin pair could not be determined from (...) the available records and therefore analysis was based on individual discrete twin data. Multivariable logistic regression was used to estimate independent risk factors, including year of birth and maternal factors, for cesarean delivery.Cesarean delivery rates for twin births increased steadily from 53.4% to 75.0% in 2008. Rates rose for the breech twin category (81.5%-92.1%) and the vertex twin category (45.1%-68.2%). The relative increase in the cesarean delivery rate for preterm and term neonates

2011 Obstetrics and Gynecology

191. Malpresentations - impact on mode of delivery. (Abstract)

Malpresentations - impact on mode of delivery. Fetal malpresentation, including persistent occipitoposterior position, is a major cause of dystocia resulting in obstetric interventions. We studied malpresentation among 11 957 consecutive singleton deliveries from 1995 to 2004. There were 1 030 deliveries with a malpresentation (8.6%). Cephalic malpresentations occurred in 5.4% of deliveries (persistent occipitoposterior 5.2%, face 0.1%, brow 0.14%), and 3.1% had breech presentation and 0.12 (...) % a transverse lie. The odds ratios (OR) for cesarean section were 14.89 (95%CI 11.91-18.63) in breech presentation and 4.57 (95% CI 3.85-5.42) in persistent occipitoposterior presentation. With persistent occipitoposterior position, the OR for instrumental vaginal delivery was 3.84 (95%CI 3.14-4.70). Primiparity was associated with increased malpresentation risks, as 54.6% of those with malpresentations were primiparous compared with 41.7% of those without (OR 1.68, 95%CI 1.48-1.91, p < 0.001). Primiparous

2011 Acta Obstetricia et Gynecologica Scandinavica

192. Trial of Labour After Caesarean

in a 4-part series on labour and delivery. DOI: To view the full text, please login as a subscribed user or . Click to view the full text on ScienceDirect. Abstract Objective To provide evidence-based guidelines for the provision of a trial of labour after Caesarean section. Outcomes Fetal and maternal morbidity and mortality associated with vaginal birth after Caesarean and repeat Caesarean section. Evidence MEDLINE database was searched for articles published from January 1, 1995, to October 31 (...) on outcomes of women with more than 2 prior Caesarean sections (I). 15 It is not an absolute contraindication for women with a breech presentation to undergo a trial of labour after Caesarean. However, women should be advised that there is insufficient information to assess risks of trial of labour after Caesarean with a breech presentation (III-B). 16 Multiple pregnancy is not a contraindication to a trial of labour after Caesarean (II-2B). 17 Women delivering with <18-month interdelivery interval should

2019 Society of Obstetricians and Gynaecologists of Canada

193. Prenatal Care

assessment, fetal imaging/ultrasound, gestational age determination, screening for aneuploidy, screening for neural tube defects, screening for diabetes/ gestational diabetes, anemia, preeclampsia, gestational hypertension, fetal movement counts, group B streptococcus, breech, membrane sweeping, identification of a pediatrician), delivery (timing, repeat cesarean delivery and vaginal birth after cesarean delivery, 17 UMHS Prenatal Care Guideline, September 2018 elective primary cesarean delivery), breast (...) , congenital anomalies, and failure to thrive. Key Points: Prenatal care summary. Table 1 summarizes the main aspects of prenatal care from preconception through delivery (history and examination; testing and treatment; education and planning). Fetal surveillance. Table 2 shows the common indications for antepartum fetal surveillance with nonstress testing and amniotic fluid index (AFI), the gestational ages at which to initiate testing, and the frequency of testing. Referral. Table 3 summarizes

2020 University of Michigan Health System

194. Maternal and Newborn Survival in Sub-Saharan Africa

, especially pneumonia and sepsis (23%) and injuries during delivery (24%). While the MDGs focused on relative reductions, the SDGs are based on absolute targets. National targets are generally more meaningful than those averaged across the globe. For instance, more than 100 countries have already hit the SDG target of 12 or fewer newborn deaths per 1,000 live births, while some 40 countries need to more than double their rate of progress to achieve it, and most of these are in Africa. About 20 African (...) and fetal growth restriction. It can also be used to identify abnormalities such as breech presentation, determine placenta location, and identify multiple pregnancies. Impact will depend on the availability of technology at a primary healthcare level, training in its correct use and most importantly the capacity of the system to then respond to screening for at-risk pregnancies and change outcomes. Fears over the use of technology for gender selection are less of a concern in Africa than in some Asian

2019 Academy of Medical Sciences

195. Guidelines For Professional Ultrasound Practice

of Radiologists (RCR) and Society and College of Radiographers (SCoR) document. SCoR/BMUS Guidelines for Professional Ultrasound Practice. Revision 3, December 2018 Minor amendments, March 2019. 9 Standard: ‘A required or agreed level of quality or attainment. A standard is a way of ensuring optimum levels of care or service delivery. Standards promote the likelihood of an ultrasound examination being delivered safely and effectively, are clear about what needs to be done to comply, are informed (...) by an evidence base and are effectively measurable’. Guideline: ‘A general rule, principle or piece of advice. Guidelines provide recommendations on how ultrasound examinations should be performed and are based on best available evidence. They help ultrasound practitioners in their work but they do not replace their knowledge and skills’. Protocol: An agreement, preferably based on research, between practitioners to ensure the delivery of high quality standardised ultrasound examinations. The title

2019 British Medical Ultrasound Society

196. Confidentiality in Adolescent Health Care

should be aware that these discussions are considered private, not secret, and obstetrician–gynecologists may disclose private information when concerned for the immediate danger of patients to themselves or others, or both, and when reporting is required by public health laws . Once confidentiality is breeched, it is difficult to regain trust; so, obstetrician–gynecologists should make efforts to avoid the violation of the trust between the health care provider and patient. Many associations (...) for adolescents and young adults: strategies and considerations for health plans . Washington, DC: NIHCM; 2011. Available at: . Retrieved November 15, 2019. Article Locations: Anoshiravani A, Gaskin GL, Groshek MR, Kuelbs C, Longhurst CA. Special requirements for electronic medical records in adolescent medicine. J Adolesc Health 2012;51:409–14. Article Locations: Gray SH, Pasternak RH, Gooding HC, Woodward K, Hawkins K, Sawyer S, et al. Recommendations for electronic health record use for delivery

2020 American College of Obstetricians and Gynecologists

197. Cardiovascular Considerations in Caring for Pregnant Patients: A Scientific Statement From the American Heart Association Full Text available with Trip Pro

, it is important to thoroughly evaluate neurological symptoms in pregnancy and to seek expert consultation ( ). Timing and Mode of Delivery Contemporary approaches to labor and delivery favor spontaneous labor and vaginal birth for the majority of women with heart disease in pregnancy. , , Cesarean delivery is known to carry increased risk of infectious morbidity and thrombotic complications and increased blood loss. In general, cesarean delivery should be reserved for obstetric indications such as breech (...) . This includes expectant management and prepregnancy counseling on cardiac medication safety throughout pregnancy and lactation phases. The cardio-obstetrics team is often made up of obstetricians, cardiologists, anesthesiologists, maternal fetal medicine specialists, geneticists, neurologists, nurses, and pharmacists who jointly develop a comprehensive strategy for management of CVD during pregnancy, delivery, and postpartum. Figure 1. Cardio-obstetrics team in the management of women before pregnancy

2020 American Heart Association

198. Overview of pregnancy complications

) progress to actual labour and delivery. The remainder of pre-term birth is due to reasons for early delivery, most commonly because of pre-eclampsia and intrauterine growth restriction. Breech presentation in pregnancy occurs when a baby presents with the buttocks or feet rather than the head first (cephalic presentation) and is associated with increased morbidity and mortality for both the mother and the baby. It is common in early pregnancy and decreases with advancing gestational age, as most babies (...) . 2011;60:1309-1316. https://www.bsg.org.uk/resource/guidelines-for-the-management-of-iron-deficiency-anaemia.html http://www.ncbi.nlm.nih.gov/pubmed/21561874?tool=bestpractice.com Symptoms include fatigue, low energy levels, and dyspnoea on exertion. Pregnancy increases demand for iron with a net loss of 680 mg of iron in 9 months or approximately 2.5 mg per day. Iron deficiency during the first 2 trimesters is associated with an increase in pre-term delivery and low birth-weight babies. Centers

2018 BMJ Best Practice

199. Erb's palsy

primitive reflexes, abnormal muscle tone, or abnormal body posture large fetal size (>4000 g) shoulder dystocia maternal diabetes (especially type 1) or gestational diabetes mellitus maternal obesity breech presentation abnormal second phase of labour assisted delivery Diagnostic investigations x-ray of chest and affected upper extremity (upper extremity 'babygram') ultrasound scan of the shoulder MRI of the shoulder CT scan of the shoulder EMG/nerve conduction studies three-dimensional proton-density (...) in order to maintain motion and prevent contracture as the nerves reinnervate muscles affected by the initial injury. Nerve reconstruction or muscle transfer surgery may be needed to improve function in children with incomplete recovery. Definition A type of brachial plexus birth palsy (a paralysis of the upper extremity due to an injury to the nerves that control movement and sensation to the upper extremity occurring at the time of birth). Often encountered as a consequence of a delivery complicated

2018 BMJ Best Practice

200. Overview of pregnancy complications

) progress to actual labour and delivery. The remainder of pre-term birth is due to reasons for early delivery, most commonly because of pre-eclampsia and intrauterine growth restriction. Breech presentation in pregnancy occurs when a baby presents with the buttocks or feet rather than the head first (cephalic presentation) and is associated with increased morbidity and mortality for both the mother and the baby. It is common in early pregnancy and decreases with advancing gestational age, as most babies (...) . 2011;60:1309-1316. https://www.bsg.org.uk/resource/guidelines-for-the-management-of-iron-deficiency-anaemia.html http://www.ncbi.nlm.nih.gov/pubmed/21561874?tool=bestpractice.com Symptoms include fatigue, low energy levels, and dyspnoea on exertion. Pregnancy increases demand for iron with a net loss of 680 mg of iron in 9 months or approximately 2.5 mg per day. Iron deficiency during the first 2 trimesters is associated with an increase in pre-term delivery and low birth-weight babies. Centers

2018 BMJ Best Practice

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