ECV | Hannah Breech Trial | Getting it out! | Potpourri | No Pain, No Gain |
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What is the earliest ECV should be attempted?
36 weeks
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What is the incidence of breech presentation
3-4%
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What are Pipers?
These forceps are used for the aftercoming breech head.
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What is vertex/vertex?
The most common presentation for twins
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What is cesarean delivery or adverse events?
In the meta-analysis by Goetzinger et al, the rate of this did not differ between the groups that received regional anes. vs non-regional pain control.
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What is the success rate for ECV?
30-70%, mean 52%
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What is perinatal or neonatal mortality less than 28 days or one or more measures of serious neonatal morbidity?
This was the primary outcome of the Term Breech Trial
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What is frank, complete and footling breech
Visual Jeopardy name in order A, B, C
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What is cord prolapse?
This severe complication occurs in 11-20% of cases of compund presentation
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What is a greater success rate of ECV with regional anesthesia?
This benefit was demonstrated in the meta-analysis but NOT all of the included RCTs.
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What are contraindictions to ECV?
nonreassuring fetal heart tracing, HIV viral load > 1000, uterine didelphys
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What is clinically? No objective measure, i.e. x-ray pelvimetry, was used.
This is how pelvimetry was assessed in the Term Breech Trial.
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What is Mauriceau-Smellie-Veit?
Simple manual effort to maximize flexion of the vertex by using pressure on the fetal maxilla.
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What is mentum anterior?
This is the mentum presentation that can delivery vaginally
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What is "reactive" or appropriate for gestational age?
A 32y/o G1P0 at 34 weeks presents ffor a NST. She is 1 cm dilated/70% effaced/0 station. The baseline is 145, moderate variability, +accels, -decels. This is how you would describe the tracing.
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What is the dose of terbutaline for a ECV?
0.25mg subcutaneous
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What is an interim analysis was performed demonstrating a statistically significant difference in the primary outcome with a p value <0.002?
Enrollment in the Term Breech Trial was stopped on April 21, 2000 with 1600 patients for this reason.
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What are Duhrssen Incisions?
three surgical incisions of an incompletely dilated cervix, corresponding roughly to 2-, 6-, and 10-o'clock, used as a means of effecting immediate delivery of the fetus when there is an entrapped head during a breech delivery.
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What is the attitude?
This word describes the position of the fetal head with relation to the neck
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What is respiratory alkalosis?
This is the acid-base disorder demonstrated by the following arterial blood gas:
7.47/28/90/3/99% |
What is 600 mcg?
This is the dose of rhogam admistered for a 60 cc whole blood maternal-fetal hemorrhage.
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What is 14?
From the results of the Term Breech Trial, this number of additional cesarean deliveries should be employed to avoid 1 baby with death or serious morbidity.
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What is turn the arm into the body?
This is what you should do in order to reduce a nuchal arm when delivering a breech fetus.
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What are brow presentations?
These often convert to vertex or face presentations and are managed accordingly
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What is the pooled RR for sucess when using regional anesthesia for an external cephalic version?
1.58
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