The most common breech presentation in a nulliparous woman is:
High-Yield Explanation
Ans: A (Frank breech) Ref: DC Dutta's textbook of obstetrics, 7th edn, pg 374Explanation:BreechMC malpresentationMC cause - prematurityEtiologyPrematurity* Maternal factors* Fetal factors* Uterine factors- multi- anomalies (hydrocephalus)- bicomuate, septate, arcuate uterus* Pelvic factors* Placental factors- contracted pelvis- placenta praevia, cornuo fundal attachment* Cord factors* Liquor factors- short cord- polyhydramnios, oligohydramniosTypes of breechComplete breechdegMore common in multi with lax abdominal wallIncomplete breechdeg Frank breech (extended breech) - MC in primideg Footling breech/knee presentationCord prolapse Incidencedeg Frank breech -- 0.5%deg Flexed breech - 5 %deg Footling breech - 15%Complicated breech - breech associated with other obstetric complications like p LSCS, placenta praevia. contracted pelvis etc.Complicated breech delivery - difficulties encountered during a vaginal breech delivery Ike extended arm etcRecurrent breech presentation - can occur in uterine anomalies like bicornuate or septate uterusDenominator - sacrumEngaging diameter- Buttocks- Shoulder- Head- bitrochanteric- bisacromial- suboccipito frontal(10 ems)(12 ems)(10 ems)