Emergency Breech Baby Delivery OB able to take patient to the OR? yes -> C-section in the OR Buttock: • Encourage mom to push with contractions until axilla/nipple appears • Never pull baby • Support baby's buttocks/emerging body until axilla/nipple appears • Once legs/hips are out, place a towel over them for warmth and better traction, and put mom into McRoberts position • Using two fingers in birth canal, push both arms medially toward baby's midline to deliver arms (goal is to prevent arms from being raised above head) • Assistant applies maternal suprapubic pressure to encourage delivery of head • Continued encouragement of mom to push with contractions, deliver head Hand/Arm: • Is presentation truly hand/arm? More common is hand pressed against face - this will self-resolve and lead to normal vertex delivery • If hand/arm is truly prolapsed beyond head, baby is horizontal/transverse lie in canal and cannot be vaginally delivered, C section required Foot/Leg: • High risk for umbilical cord prolapse/compression. C section is mandatory if baby is still viable • Viability can be established by palpating pulsatile umbilical cord, or by checking sonographic fetal heart rate #Breech #Delivery #Emergency #management #obstetrics #obgyn #baby
