What is Frank Breech?

Appeared in: DSSSB 12 August 2024

Explanation

Frank breech is a specific type of malpresentation where the fetus's buttocks are the presenting part.
It is defined by the fetal attitude: the hips are flexed (bent toward the abdomen), and the knees are extended (legs are straight).
This position places the fetus's feet up near its head.
Frank breech is the most common of all breech presentations, accounting for about 65-70% of cases.

Option A: A footling presentation is a type of incomplete breech where one or both feet are the presenting part, positioned below the buttocks.
Option C: A knee presentation is a rare variant of incomplete breech where the thigh is extended, but the knee is flexed, causing the knee to be the presenting part.
Option D: Breech with flexed legs (and flexed hips) is known as a complete breech. In this position, the fetus appears to be sitting cross-legged.

Clinical Relevance

Nursing practice connection: This is primarily an exam-oriented knowledge point with limited direct bedside application, so retain Classification of fetal breech presentations in obstetrics as background academic context rather than a clinical decision trigger.
Correctly identifying the type of breech presentation is critical for determining the safest mode of delivery and managing potential complications.
Frank breech presentations have a relatively lower risk of cord prolapse compared to footling or complete breeches, and may be considered for a trial of vaginal labor under strict selection criteria.
A nurse's role includes assisting in the identification of fetal presentation through Leopold's maneuvers and preparing for the appropriate mode of delivery, including potential complications like cord prolapse or head entrapment.

How to Approach the Question

This is a factual recall question testing knowledge of obstetric terminology.
First, identify the core concept: 'Breech presentation,' which means the fetus is positioned buttocks or feet first for delivery.
Next, recall the specific definitions for the different types of breech presentations based on the position of the fetus's legs.
Associate 'Frank' breech with the legs being extended at the knees, making them straight and pointing upwards towards the fetal head.
Differentiate this from 'Complete' breech (hips and knees flexed, like sitting) and 'Footling' breech (one or both feet presenting first).
Select the option that accurately describes the legs as extended.

Concept Tested & Keywords

QI328NLGdIyKtJhsP9NXCR

E6 Midwifery Obstetrics and Gynecology Nursing Sandeep Kaur p. 46-54

E6 Obstetrics Williams p. 21-40

Practise the full DSSSB 12 August 2024

Attempt every question from this paper in a timed mock, then review the full solution for each one.