IGNOU PB Bsc Entrance-2022
Obstetrics & Gynaecology
Medium
Methods of delivering the after coming head of breech presentation are all the following, except:
Appeared in: IGNOU PB Bsc Entrance-2022
Explanation
- Vacuum extraction is the correct answer because it is not a valid method for delivering the after-coming head in a breech presentation.
- The vacuum cup (ventouse) is designed for application to the fetal vertex in a cephalic (head-first) presentation.
- Using a vacuum extractor on the after-coming head is contraindicated due to the high risk of severe fetal injury, including trauma to the neck, spinal cord, and cranium.
Why Other Options Were Wrong
- Option A: This is an incorrect choice because the Burns-Marshall technique is a recognized and valid maneuver for delivering the after-coming head in a breech presentation.
- Option B: This is an incorrect choice because the Mauriceau-Smellie-Veit technique is a classic and valid maneuver for managing the after-coming head.
- Option C: This is an incorrect choice because forceps extraction, using specialized instruments like Piper forceps, is a valid and often preferred method for the controlled delivery of the after-coming head.
Related Visual
Clinical Relevance
- Nursing practice connection: This is primarily an exam-oriented knowledge point with limited direct bedside application, so retain Management of the after-coming head in a breech presentation as background academic context rather than a clinical decision trigger.
- Knowing the appropriate and safe techniques for managing a vaginal breech delivery is a critical skill in obstetrics, especially in emergency situations where a cesarean section is not immediately possible.
- Improper technique or the use of contraindicated methods like vacuum extraction can lead to catastrophic fetal injuries, including cervical spine dislocation, brachial plexus injury, and intracranial hemorrhage.
- While planned vaginal breech delivery is less common today, with cesarean section being the preferred mode of delivery for most breech presentations to minimize risk, these manual skills remain essential for unexpected or rapid breech births.
How to Approach the Question
- First, identify that the question uses the word 'except', which means you are looking for the option that does NOT fit with the others.
- The question asks for methods of delivering the after-coming head in a breech presentation.
- Review each option and determine if it is a recognized technique for this specific obstetric situation.
- Recall or deduce that Burns-Marshall, Mauriceau-Smellie-Veit, and specialized forceps are all established maneuvers for vaginal breech delivery.
- Identify that vacuum extraction is designed for cephalic presentations and is unsafe and contraindicated for the after-coming head.
- Therefore, vacuum extraction is the exception and the correct answer.
Concept Tested & Keywords
- Concept Tested: Management of the after-coming head in a breech presentation.
- Stem keywords: delivering, after coming head, breech presentation
- Lead-in keywords: except
- Negative lead-in flag: Question is negatively framed (EXCEPT)
Question ID
Q6IBYrfJrP0XSF58YfR_7U
Reference Book
E6 Obstetrics Williams p. 28-46
E6 Midwifery Obstetrics and Gynecology Nursing Sandeep Kaur p. 48-56
Practise the full IGNOU PB Bsc Entrance-2022
Attempt every question from this paper in a timed mock, then review the full solution for each one.
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