Mechanism of labor for breech position?

after you confirmed with etiology and diagnosis of breech presentation, we can move to the management of labor.Mechanism of labor can be done in different method after evaluvating the position and size of the fetus.

Favourable factors for vaginal breech delivery are

1.averaged sized baby.

2.adequate pelvis

3.frank or complete breech

4.good labor progress

5.easy and spontaneous delivery of buttocks and thighs

METHOD ONE: mother sitting 45* at her back

IV infusion,emptied bladder,deflate the urinary catheter bulb before delivery.oxytocin infusion.use manual assist once we seen with hair line after shoulder.

baby on right forearm,3rd finger on baby's mouth region,2nd and 4th finger on baby's mandible.2nd and 4th finger of left over the shoulder ,and 3rd finger on occiput region,to maintain the flexion,where the head is carefully delivered.

2nd breech delivery-splitting two legs separate and delivering one by one,by flexion and rotating the body of the back faces anteriorly.anterior arm is delivered by passing two fingers along the humerus towards the elbow.posterior shoulder delivered by lifting the baby upwards,then mother move downwards to make the head has engaged in pelvis, raise baby's head up slightly towards the oblique diameter,flext it and pull down gently,supra-pubic pressure may be used to assist flexion.

3rd breech delivering method:-hold the baby's ankle with your left hand,swing the baby upto an arch in a vertical position,then to mother's abdomen.

4th:-forceps method- hold the baby's ankle with your left hand and swing upto an arch position ,hold by an assistant.use long curve forceps.with the right lubricated hand, gently guide the forceps on your left hand towards the posterio lateral position.apply the left plate of forceps in same fashion,this time use your left lubricated hand to guide into the position.confirm the correct position by locking the hands easily.baby's face symmetrically positioned between the forceps plate.deliver the head by steady traction of the handle and downward pressure on the shacks with the left hand.so the resultant pull follows the curves of the pelvis.if the head cannot be delivered consider rapid cesarean section or symphysiotomy technique.

5th method:-symphysiotomy-infuse the tissue with local anesthetics,pass a firm plastic catheter through the urethra and index finger of your left hand along the catheter into vagina,and move the urethra from the midline.make small scalpel incision on the lower part of the symphisis pubis angle the blade towards the topof the symphisis pubis,cut the anterior fiber of symphisis pubis,with top to bottom keeping a thin layer.now delivering the baby with forceps or by 1st method.