Frank breech presentation

HASANAH

DEFINITION
Frank

breech

presentation

is

situation where the fetus lenghtwise

with the head at fundus uteri and
buttocks is below the low part of
cavum uteri

Clacification
a.

Frank breech presentation is a presentation of feet

upraised to the top so that toes as high as shoulder
or fetus head.

b. Complete

(full),

is

feet

and

hands

crosswise

perfectly and beside the buttocks the feet can be

palpated.
c.

Incomplete breech (foot/knee) presentation, is only

one foot beside the buttocks, the other foot is
upraised.

Etiology
a. Prematurity
b. Gemelli
c. Hydroamnion
d. Hydrocephalus
e. Placenta previa
f. Multyparity
g. Narrow pelvis
h. Tumor of birth canal

Mechanism of Frank breech

presentation
a. Compaction/engagement
b. Descent
c. Lateroflexion of fetus body
d. Internal rotation from buttocks, head and

shoulder
e. Flexion from head

Prognotion of child
Mortality of baby reachs 30% because the factors
as follows
a.

Prematurity

b.

Etiology of Frank breech presentation (CPD, narrow

pelvic, placenta previa)

c.

Hipoxia (occurs when umbilical cord opressed by

body and head of placenta more than 8 minutes)

d.

Brain bleeding because head compression is too fast

continue
e.

Interference in child birth, example hand

tipping, after coming head.

f.

Because action of helper, example: humeral

fracture, damage to the neck nerves, plexus
brachialis

Prognosa toward Mom

Cervix laceration, because opening is not

complete (especially left side, knee)

infection, because hands helper enter
vaginal canal
Post partum bleeding, because:
- birth canal laceration
- breech complication, because placenta
previa,
hidromnion (atonia uteri)

Procedurs to help Frank breech

presentation
1. Spontan : Bracht
2. Partial extraction/manual Aid :
. Muller
. Classic
. Lovset
. Mauriceau
3. Full extraction
. Extraction

SPONTANEOUS BRACHT

Janin dilahirkan
dengan kekuatan
dan tenaga ibu
sendiri

Partial exraction/manual aid

Janin

dilahirkan

sebagian

dengan tenaga dan kekuatan

ibu dan sebagian lagi dengan
tenaga penolong.

Full Extraction
Janin
dilahirkan

seluruhnya

dengan

memakai

tenaga

penolong

Criteria of value according to Breech index Zatuchni Andros

score

parity
Gestational age
Assessment BJ
Breech history
Estimation weight
of fetus
Cervix opening
Buttocks down

Primi
39 week
3630 gr
0
2 cm
-3/> high

Multi
38 week
3629-3176 gr
1
3 cm
-2

0-3 : score low

4-11 : skore hight

2
37 week
3175 gr
2

4 cm
1/> low

Need to remember
On breech aid always done by epsiotomi on

primi or multi

Indication for SC
Bad obstetri history
Old primi
Infertility history
Head deflection
There is anomali on canal birth (tumor,

narrow pelvic, etc)

THANK YOU