AIIMS Delhi NO - 2017
Obstetrics & Gynaecology
Medium
Look at below given image and identify the correct type of breech Presentation?
Appeared in: AIIMS Delhi NO - 2017
Explanation
- The image clearly shows the fetus with its buttocks presenting at the pelvic inlet.
- The fetal hips are flexed, meaning the thighs are bent up towards the abdomen.
- The fetal knees are extended, meaning the legs are straight, with the feet near the head.
- This specific combination of flexed hips and extended knees is the definition of a Frank Breech presentation.
- It is the most common type of breech presentation.
Why Other Options Were Wrong
- Option B: In a footling breech, one or both of the fetus's hips are extended, causing one or both feet to present first in the birth canal. The image shows both hips flexed.
- Option C: In a complete breech, both the hips and knees are flexed, making the fetus appear as if it is sitting cross-legged. The image shows the knees are extended, not flexed.
- Option D: This option is incorrect because a correct identification can be made from the given options. The image clearly depicts a standard type of breech presentation.
Related Visual
Clinical Relevance
- Nursing practice connection: This is primarily an exam-oriented knowledge point with limited direct bedside application, so retain Identification of breech presentation types in obstetrics as background academic context rather than a clinical decision trigger.
- Accurate identification of breech presentation is critical for planning the mode of delivery. While cesarean section is common for breech presentations, a trial of vaginal delivery may be considered for Frank breech under specific criteria.
- Nursing assessment includes performing Leopold's maneuvers to determine fetal lie and presentation. If a breech presentation is suspected, it is confirmed with an ultrasound.
- Nurses play a key role in counseling the patient about the options, risks, and benefits of vaginal versus cesarean delivery for a breech presentation, and preparing them for the chosen method.
How to Approach the Question
- First, carefully analyze the provided image of the fetus in the uterus.
- Identify the presenting part: notice that the buttocks are positioned downwards, towards the birth canal.
- Observe the fetal attitude, specifically the position of the legs. Note that the hips are flexed (bent) and the knees are extended (straight).
- Recall the definitions of the different types of breech presentations: Frank, Complete, and Footling.
- Compare your visual findings with the definitions. The posture in the image (flexed hips, extended knees) directly matches the definition of a Frank Breech.
- Eliminate the other options based on their definitions: Complete breech involves flexed knees, and Footling breech involves extended hips with feet presenting first.
Concept Tested & Keywords
- Concept Tested: Identification of breech presentation types in obstetrics.
- Stem keywords: breech presentation, fetus, image identification
- Lead-in keywords: identify, correct type
- Clinical cues: The visual depiction of the fetus's posture, specifically the flexion of the hips and extension of the knees.
Question ID
QCdipJXigIpKee5jrAL1cX
Reference Book
E6 Midwifery Obstetrics and Gynecology Nursing Sandeep Kaur p. 46-54
E6 Obstetrics Williams p. 21-40
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