A 30-year-old G2P1L1 at 37 weeks gestational age is here for a routine visit. Her first was a vaginal delivery of a 4.3 kgs baby boy after 30 min of pushing. This fetus is breech. Vaginal exam demonstrates that the cervix is 50% effaced and 1 to 2 cm dilated. The presenting breech is high out of the pelvis. The estimated fetal weight is about 3.2 kgs. A sonogram confirms a fetus with a frank breech, normal amniotic fluid present, and the head is well flexed. The following are possible management plans except:
-External cephalic version can be done in this case because Period of gestation is 37 weeks(ideal time) Liquor is adequate - Frank breech is the best breech for vaginal delivery, so a trial of labor is given. whereas in case of footling breech, an Elective L.S.C.S is done. - Vaginal breech delivery can be assisted and is allowed to progress and at whichever sage , breech get stuck , the obstetrician can perform C-section. - Pinard's maneuvre is done for delivery of extended legs. There is no indication for performing and Elective LSCS at this moment at 37 weeks, unless there were any other obstetric indication like a previous LSCS or placenta pre etc.
Allow the patient to undergo a vaginal breech delivery whenever she goes into labor
Cesarean section now
Pinard's maneuver can be done for delivery of extended legs
Schedule an external cephalic version in the next few days
Obstetrics