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Breech mech of labour

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Breech mech of labour

  1. 1. Mechanism of labour in breech Amarendra B. Singh 090201263
  2. 2. Positions * Left sacro-anterior. * Right sacro-anterior. * Right sacro-posterior. * Left sacro-posterior. * Left and right sacro- transverse (lateral). * Direct sacro-anterior and posterior. Breech - Mech of labour8/18/2013 2
  3. 3. 8/18/2013 Breech - Mech of labour 3
  4. 4. Mechanism of labour • Delivery of the breech (Buttocks and lower limbs) • Delivery of the shoulders and arms • Delivery of the head 8/18/2013 Breech - Mech of labour 4
  5. 5. Delivery of lower limbs and buttocks • Engagement • Descent • Flexion • Internal rotation • Birth of Buttocks 8/18/2013 Breech - Mech of labour 5
  6. 6. Delivery of the buttocks * The engaging diameter is the bitrochanteric diameter 9.5cm which enters the pelvis in one of the oblique diameters. Breech - Mech of labour8/18/2013 6
  7. 7. The anterior buttock meets the pelvic floor first so it rotates 1/8 circle anteriorly . * The anterior buttock hinges below the symphysis 8/18/2013 Breech - Mech of labour 7
  8. 8. and the posterior buttock is delivered first by lateral flexion of the spines followed by the anterior buttock. * External rotation occurs so that the sacrum comes anteriorly. 8/18/2013 Breech - Mech of labour 8
  9. 9. Delivery of shoulders and arms • Engagement • Descent continuous • Internal rotation • Birth of shoulders • Restitution 8/18/2013 Breech - Mech of labour 9
  10. 10. Delivery of the shoulders * The shoulders enter the same oblique diameter with the bisacromial diameter 12 cm (between the acromial processes of the scapulae). 8/18/2013 Breech - Mech of labour 10
  11. 11. • The anterior shoulder meets the pelvic floor first, rotates 1/8 circle anteriorly, hinges under the symphysis, then the posterior shoulder is delivered first, the baby is then lowered and the anterior shoulder and arms pass out under the symphysis. 8/18/2013 Breech - Mech of labour 11
  12. 12. Birth of after coming head • Engagement • Descent • Flexion • Internal rotation • Birth of the head 8/18/2013 Breech - Mech of labour 12
  13. 13. • Descent and Engagement: The head enters the pelvis in the left oblique diameter. The occiput is in the right anterior quadrant of the pelvis. 8/18/2013 Breech - Mech of labour 13
  14. 14. • Flexion: It is important that flexion is maintained. • Internal rotation: The head strikes the pelvic floor and rotates internally so that sagittal suture comes to lie in anteroposterior diameter. 8/18/2013 Breech - Mech of labour 14
  15. 15. • Birth of the head by flexion: The nape of the neck pivots under the symphysis and the chin, mouth, nose, forehead, bregma, and occiput are born over the perineum by a movement of flexion. 8/18/2013 Breech - Mech of labour 15

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