A 25-year-old, G2P1L1 woman has come to the emergency at 37wks with mild pains. On examination she is found to have breech presentation with os closed and partially effaced cervix. What is the next step?
Ans. A. Schedule an urgent ultrasounda. Based on the clinical examination, the woman is in false labor.b. The next step is to schedule an urgent ultrasound to help us make our plan of delivery for the woman.All woman with breech pregnancy are offered External cephalic version if no contraindications exist. ECV should be performed at >36 completed weeks of gestation, because chances of reversion to breech are less. Also, fetal maturity has been achieved, in case immediate delivery is required while performing ECV. Such necessity can arise in case of fetal distress or abruption, which can happen during ECV. ECV can be done even in latent phase of labor.Following Contraindications to ECV can be ruled out by performing an ultrasound examination:a. Oligohydramniosb. IUGRc. Macrosomiad. Gross congenital anomaly in the fetuse. Placenta previaAlso, absolute indications of caesarean section in breech pregnancy can also be identified, such as footling breech and stargazer breech (extended head)
Schedule an urgent ultrasound
Check OT and prepare for ECV
Wait and watch for spontaneous breech vaginal delivery
Schedule an emergency caesarean section
Operative Obs