In which breech presentation, the presenting part consists of the two buttocks and external genitalia only?

RRB Nsg. Superintendent -29 April-2025 (shift-2nd)

Obstetrics & Gynaecology

Easy

Appeared in: RRB Nsg. Superintendent -29 April-2025 (shift-2nd)

Explanation

Frank breech is a type of breech presentation where the fetus's hips are flexed, and the knees are extended.
This position brings the fetal legs up alongside its trunk, with the feet near the head.
Consequently, the only parts of the fetus entering the maternal pelvis first are the buttocks and external genitalia.
This is the most common form of breech presentation, accounting for the majority of cases.

Option B: In a footling presentation, one or both hips and legs are extended, causing one or both feet to be the presenting part, situated below the buttocks.
Option C: Flexed breech, also known as complete breech, involves flexion at both the hips and knees. The fetus appears to be sitting cross-legged. The presenting parts are the buttocks AND the feet together.
Option D: Knee presentation is a rare variation where the fetus's hips are extended, but the knees are flexed, causing one or both knees to present at the pelvic brim.

Visual 1: Diagram - An illustration comparing the four types of breech presentations (Frank, Complete/Flexed, Footling, and Knee) side-by-side. This visual helps clarify the different positions of the fetal legs and what constitutes the presenting part in each case.

Clinical Relevance

Nursing practice connection: This is primarily an exam-oriented knowledge point with limited direct bedside application, so retain Types of Breech Presentation in Obstetrics as background academic context rather than a clinical decision trigger.
Breech presentations are associated with a higher risk of complications during labor and delivery, such as umbilical cord prolapse and head entrapment.
Management options for a term breech presentation include External Cephalic Version (ECV) to turn the fetus to a head-down position, planned vaginal breech delivery in selected cases, or a planned cesarean section.
Footling and knee presentations carry a higher risk of cord prolapse than frank or complete breech because the presenting part does not fill the pelvis as effectively, leaving space for the cord to slip down.

How to Approach the Question

First, identify the core of the question, which is asking to identify a specific type of breech presentation based on the description of the presenting part.
The key phrase is "two buttocks and external genitalia only."
Recall the definitions and characteristics of the different types of breech presentations: Frank, Complete (Flexed), Footling, and Knee.
Systematically compare the description in the question to the definition of each option.
Frank breech: Hips flexed, knees extended. Presenting part is buttocks only. This matches the question.
Complete breech: Hips and knees flexed. Presenting part is buttocks and feet.

Concept Tested & Keywords

Concept Tested: Types of Breech Presentation in Obstetrics
Stem keywords: breech presentation, presenting part, buttocks, external genitalia
Lead-in keywords: In which

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