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Gynaecology & Obstetrics Operative Obs dfaa30dd

Which is not an indication for a classical cesarean incision?

A
Cannot visualize the lower uterine segment
B
Transverse lie
C
Premature breech
D
Term breech (frank)
High-Yield Explanation
Ans. D. Term breech (frank)Occasionally it is necessary to use a classical incision for delivery. Some indications are:a. Difficulty in exposing or safely entering the lower uterine segment because the bladder is densely adherent from previous surgery, a myoma occupies the lower uterine segment, or the cervix has been invaded by cancer.b. Transverse lie of a large fetus, especially if the membranes are ruptured and the shoulder is impacted in the birth canal. A fetus presenting as a back-down transverse lie may be particularly difficult to deliver through a transverse incision.c. Some cases of placenta previa with anterior implantation, especially in the case where the placenta has grown through a prior uterine incision (placenta percreta).d. Certain cases in which the fetus is very small, especially if breech, and the lower uterine segment is not thinned out.e. Massive maternal obesity precluding safe to the lower uterine segment.

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