FACE PRESENTATION DIGNOSTIC LANDMARKS-EYES,NOSE MOUTH AND CHIN POSITION-MENTO ANTERIOR/POSTERIOR,MENTO TRANSVERSE MANAGEMENT GUIDELINES-FETUS IS DEAD OR ALIVES WITH ANOMALIES INCOMPATABLE WITH LIFE,ALLOW VAGINAL DELIVERY MENTO ANTERIOR,R/O FPD

FACE PRESENTATION AND BROW IF LABOUR IS PROGRESSING WELL MENTO POSTERIOR- C/S BROW -NORMALLY INCOMPATABLE WITH VAGINAL DELIVERY DIAGNOSTIC LANDMARKS-ROOT OF THE NOSE,SUPRAORBITAL RIDGES,ANTERIOR FONTANEL MANAGEMENT - CESARIAN SECTION

SHOULDER PRESENTATION DIAGNOSTIC LANDMARKS UTERUS IS ENLARGED TRANSVERSLY AND SHORTENED VERTICALLY EMPTINESS AT THE LOWER POLE ON PV PALPABLE CLAVICLE,RIBS ARM PROLAPSE

MANAGEMENT WITH FETUS ALIVE –C/SECTION WITH FETUS DEAD-DESTRUCTIVE OPERATION,OR C/S COMPOUND PRESENTAION PROLAPSE OF ONE OR MORE LIMBS IN CEPHALIC PRESENTATION PROLAPSE OF HAND OR ARM IN BREECH PRESEENTATION

COMPOUND PRESENTATION PUSH THE HAND ABOVE THE FETAL HEAD ARM MAY BE DIFFICULT TO REPLACE AND CESARIAN SECTION MAY BE NECESSARY MALPOSITION INCORRECT POSITIONING OF THE VERTEX OCCIPITO POSTERIOR POSITION PERSISTENT O.P.P

0CCIPITO POSTERIOR POSITION DIAGNOSIS PALPATION AUSCULTATION VAGINAL EXAMINATION LONG ROTATION-135° --OCCIPITO ANTERIOR- SVD EXPECTED SHORT ROTATION- 45°--FACE TO PUBIS—AVD OR C/SECTION

MALPRESENTATION ANY PRESENTATION OTHER THAN THE NORMAL VERTEX OF THE FETAL HEAD

MALPRESENTAION FACE BROW SHOULDER BREECH COMPOUND

CAUSES OF MALPRENTATION HIGH PARITY PREMATURITY FETAL ANOMALIES POLYHYDRAMNIOS MILD CPD

BREECH PRESENTATION WHEN THE BUTTOCKS AND/OR THE FEET ARE THE PRESENTING PARTS THE COMMONEST MALPRESENTATION HAS HIGHER PERINATAL MORTALITY AND MORBIDTY CAUSES OF BREECH PRESENTATION- PREMATURITY,MULTIPLE PREGNANCY,FETAL MALFORMATION,HYDRAMNIOUS

CLASSIFICATION AND RISKS COMPLETE FRANK FOOTLING INTRAPARTUM RISK TO THE FETUS-CORD ACCIDENTS,FRACTURE AND DISLOCATION OF LIMBS,DAMAGE TO INTRA-ABDOMINAL ORGANS,INTRACRANIAL HAEMORRHAGE,DAMAGE TO THE CERVICAL SPINE AND BRACHIAL PLEXUS

MANAGEMENT UNCOMPLICATED BREECH ELECTIVE C/S? PLANNED VAGINAL DELIVERY? FRANK BREECH C0MPLETE BREECH FOOTLING

VAGINAL DELIVERY KEEP MEMBRANES INTACT AS LONG AS POSSIBLE BREECH IS SMALLER THAN THE AFTER COMING HEAD BEFORE BEARING DOWN THE CERVIX MUST BE FULLY DILATED LET THE BREECH DESCEND TO THE PERINEUM

ANATOMICAL LANDMARKS ANTERIOR BUTTOCKS BEGIN TO DISTEND PERINEUM- ACTION? THEN POSTERIOR BUTTOCKS- ACTION? HIPS –LEGS FLEXED- ACTION? HIPS- LEGS EXTENDED-ACTION? UMBILICUS- ACTION? SCAPULA- ACTION? NAPE OF THE NECK-ACTION?

SPECIAL MANOEUVRES PINARDS MAURICEAU-SMELLIE-VEIT LØVESET PRAGUE REVERSE PRAGUE FORCEPS

Complications of breech delivery EXTENDED ARMS NUCHAL ARM OCCIPUT POSTERIOR OF THE AFTERCOMING HEAD HEAD ENTRAPMENT BY INCOMPLETELY DILATED CERVIX

BREACH EXTRACTION IS THERE A PLACE FOR BREECH EXTRACTION?