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Managing Complications in Pregnancy and Childbirth: - IAWG

Managing Complications in Pregnancy and Childbirth: - IAWG

Managing Complications in Pregnancy and Childbirth: - IAWG

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BREECH DELIVERY P-37• Review for <strong>in</strong>dications. Ensure that all conditions for safe vag<strong>in</strong>albreech delivery are met.• Review general care pr<strong>in</strong>ciples (page C-17) <strong>and</strong> start an IV <strong>in</strong>fusion(page C-21).• Provide emotional support <strong>and</strong> encouragement. If necessary, use apudendal block (page P-3).• Perform all manoeuvres gently without undue force.COMPLETE OR FRANK BREECHFIGURE P-13Breech presentationDELIVERY OF THE BUTTOCKS AND LEGS• Once the buttocks have entered the vag<strong>in</strong>a <strong>and</strong> the cervix is fullydilated, tell the woman she can bear down with the contractions.• If the per<strong>in</strong>eum is very tight, perform an episiotomy (page P-71).• Let the buttocks deliver until the lower back <strong>and</strong> then the shoulderblades are seen.• Gently hold the buttocks <strong>in</strong> one h<strong>and</strong>, but do not pull.• If the legs do not deliver spontaneously, deliver one leg at a time:- Push beh<strong>in</strong>d the knee to bend the leg;- Grasp the ankle <strong>and</strong> deliver the foot <strong>and</strong> leg;- Repeat for the other leg.

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