Obgyn: Breech Presentation: Free MSRA Podcast

⚕️ FREE MSRA PODCAST – Breech Presentation🎧 A clear, high-yield breakdown of this common late-pregnancy complication – perfect for exam prep and real-life clinical scenarios.🧠 Key Learning Points📌 Definition• A foetal presentation where the baby’s buttocks or feet present first instead of the head in a longitudinal lie.• Increases perinatal risks and influences delivery planning.📌 Causes & Risk Factors• Prematurity• Multiple pregnancy• Uterine anomalies (e.g. fibroids)• Placenta previa• Polyhydramnios or oligohydramnios• Foetal abnormalities (e.g. hydrocephalus)• High parity, smoking, maternal diabetes🧠 Mnemonic: “MUPPET” – Multiple pregnancy, Uterine abnormality, Placenta previa, Polyhydramnios, Excess babies (multiparity), Teratology (foetal anomalies)📌 Pathophysiology• Exact mechanism is often unknown• Thought to be linked to limited intrauterine space, abnormal uterine shape, or impaired foetal movement📌 Symptoms• Head palpated at uterine fundus• Soft mass in pelvis (buttocks)• Fetal heart heard above umbilicus• Irregular foetal movements reported🧠 VE may detect sacrum/anus/foot if in labour📌 Differential Diagnosis• Transverse lie• Oblique lie• Cephalic presentation with abnormal engagement📌 Diagnosis• Clinical suspicion via abdominal palpation• Confirmed with ultrasound (crucial at 36 weeks)💡 Scan also checks for underlying anomalies📌 Management• External cephalic version (ECV) at 36–37 weeks – Success rate 30–80% – Contraindications rare (~4%)• If persistent breech: – Offer vaginal breech delivery if criteria met (e.g. frank breech, skilled team) – Planned C-section if risk outweighs vaginal delivery• NICE: Offer ECV if no contraindications, confirm position before C-section, ensure shared decision-making📌 Complications• Cord prolapse (↑ in footling/complete types)• Fetal head entrapment• Birth trauma (fractures, cervical spine injury)• Neonatal asphyxia• Maternal: Prolonged labour, PROM, premature labour📌 Prognosis• 2–4x ↑ in perinatal mortality vs cephalic presentation• Linked to prematurity, congenital abnormalities, delivery type• All breech babies need hip ultrasound postnatally to screen for DDH📎 More MSRA Resources for Breech Presentation📝 Revision Notes: https://www.passthemsra.com/topic/breech-presentation-revision-notes/🧠 Flashcards: https://www.passthemsra.com/topic/breech-presentation-flashcards/💬 Accordion Q&A Notes: https://www.passthemsra.com/topic/breech-presentation-accordion-qa-notes/🚀 Rapid Quiz: https://www.passthemsra.com/topic/breech-presentation-rapid-quiz/🎓 Full Course: https://www.passthemsra.com/courses/obstetrics-and-gynaecology-for-the-msra/Hashtags#MSRA #MSRARevision #MSRATextbook #MSRAQuiz #MSRAQuestionBank #MSRAFlashcards #MSRAQANotes #MSRAAccordions #MultiSpecialityRecruitmentAssessment #MSRAOnlineRevision #MSRARevisionWebsite #BreechPresentation #ObstetricsAndGynaecology #MSRAObstetrics