A. Understanding
Layout Breech
Breech
position is elongated layout with buttocks as part of the lowest (percentage
buttocks). Breech
position is divided as follows:
1.Letak
pure breech that is involved in the buttocks while the front legs straight up.
2.Letak buttocks legs
3.Letak knee
4.Letak feet
The
frequency of pure breech position higher in early pregnancy than pregnancy and
multigravida more than primigravida.
B. Etiology
Location of Breech
The cause lies Sungang:
1.Fiksasi
head on the pelvic not good or does not exist, for example in panggulsempit,
hydrocephalus, placenta previa, tumor - pelvic tumors and others - others.
2.Janin
easy to move, such as hydramnios, multipara, small fetus (premature).
3.Gemeli (multiple pregnancy)
4.Kelainan
uterus, such as uterine arkuatus; bikornis, myoma uteri.
5.Janin sedah long dead.
6.sebab unknown.
C. Classification
1.Letak breech (frank
breech)
Location
of buttocks with both legs lifted up (75%)
2.Letak
perfect breech (breech Complete)
The
layout of the buttocks where there legs beside the buttocks (butt location is
perfect feet / folding seizures)
Breech
3.Letak imperfect (incomplete breech)
breech
position which is in addition to the lowest part buttocks legs and knees as
well, consisting of:
- Kadua feet: Location
of perfect legs
One foot: foot
layout is not perfect
- Both knees: knee
layout is perfect
One knee: knee
layout is not perfect
The
position is determined by the sacrum buttocks, there are 4 positions:
1) Left
anterior sacrum (the sacrum front left)
2) Right
anterior sacrum (the sacrum front right)
3) Left
sacrum posterior (rear left sacrum)
4) Right
sacrum posterior (rear right sacrum)
D. Signs
and Symptoms of Placemark Breech
1. The
movement felt by the child's mother down below the center of the abdomen and
mothers often feel a hard object (head) urged the ribs.
2. On
palpation palpable hard parts, round and bouncy at the fundus uteri.
3. Child's
back can be felt on one side of the abdomen and prayers small parts on opposite
sides. Above
sympisis budar the less palpable and tender.
4. Fetal
heart sounds audible on the child's back as high as the center.
E. Diagnosis
1. Palpation
Head
palpable fundus, lower buttocks, and back frame on the left or right.
2. Auscultation
DJJ
most clearly audible at a higher place than the center.
DDJ X DJJ X
3. Examination of
the
Can
be palpated os sacrum, tuber ischii, and anus, sometimes - sometimes feet (on
the location of the foot)
Distinguish between:
- Small hole - Sucking
- Bones (-) - Jaw Mouth
- Sip (-) Anus - Tongue
- Mekoneum (+)
- Heel - Finger length
- Angle 90 0
Feet - No Hands average elbow
- Average finger - the
finger - patella (-)
- Patella knee
- Popliteal
4. X-ray examination:
the shadow of the head in fundus
F. Pathophysiology Maternity
Location of Breech
Baby breech position
because:
1. Hydramnios: children
easy to move because of the mobilization
2. Placenta
Previda: Block head down to the pelvis
3. Pelvic
Cramped: Head trouble adjusting to the birth canal