30. Partial Breech Extraction
Steps in Delivery (Frank Breech):
1. HANDS OFF – Wait for the baby to
deliver until the Umbilicus
Rawa Muhsin https://www.youtube.com/watch?v=gmnr_MTyKwc
31. Pinard Maneuver:
Press on the popliteal fossa to
flex the knee
Hence, deliver both legs
Rawa Muhsin https://www.youtube.com/watch?v=gmnr_MTyKwc
32. Deliver the cord to prevent cord
compression
Rawa Muhsin https://www.youtube.com/watch?v=gmnr_MTyKwc
33. Sweep across baby’s face to
deliver one arm
Rawa Muhsin https://www.youtube.com/watch?v=gmnr_MTyKwc
34. In case of a nuchal arm …
Lovset Maneuver:
Rotate baby to aid the delivery
of the other arm
Rawa Muhsin https://www.youtube.com/watch?v=gmnr_MTyKwc
35. Sweep across baby’s face to
deliver the other arm
Rawa Muhsin https://www.youtube.com/watch?v=gmnr_MTyKwc
36. Delivery of
aftercoming head
1st Hand:
Baby’s maxilla lifted by index
finger + middle finger
Rest the baby’s body on the
hand + forearm
2nd hand:
Use index finger + middle
finger to grasp the baby’s
shoulder
Assistant: (Crede Maneuver)
Apply suprapubic pressure
1. Mauriceau-Smellie-Veit
maneuver
Rawa Muhsin https://www.youtube.com/watch?v=gmnr_MTyKwc
37. Delivery of
aftercoming head
2. Burns-Marshall
maneuver
Feet are grasped and with
gentle traction swept in a slow
arc over the maternal
abdomenRawa Muhsin https://www.youtube.com/watch?v=gmnr_MTyKwc
38. Delivery of
aftercoming head
2. Burns-Marshall
maneuver
Feet are grasped and with
gentle traction swept in a slow
arc over the maternal
abdomen
Rawa Muhsin https://www.youtube.com/watch?v=gmnr_MTyKwc
44. Both twins are in breech
presentation
Twin A is vertex, but Twin B is breech
• Vaginal of Twin A
then.
• External cephalic version
• Breech extraction
• C-section for the Twin B (vaginal-plus-C-section
If both twins were breech
• C-section
https://www.ijrcog.org/index.php/ijrcog/article/view/572/528
45. If Twin A is breech, Twin B is cephalic
• C-section
• Vaginal delivery can be considered as an
option for first twin breech specially in
multigravida – but is associated with an
increased chances of Locking/Locked
Twin
Leading twin in breech presentation, is routine caesarean section
necessary?
Lopamudra B. John, Reddi Rani P., Seetesh Ghose (Vol5 No2, 2016)
https://www.ijrcog.org/index.php/ijrcog/article/view/572/528