version
Indication of internal podalic version is?
| A | Transverse lie | |
| B |
Transverse lie of second twin |
|
| C | Breech | |
| D |
Polyhydramnios |
Indication of internal podalic version is?
| A | Transverse lie | |
| B |
Transverse lie of second twin |
|
| C | Breech | |
| D |
Polyhydramnios |
Transverse lie of second twin
REF: Dutta 6th ed p. 388
The only indication of internal cephalic version is transverse lie in the second twin
| A | Contracted pelvis | |
| B |
Antepartum hemorrhage |
|
| C |
Multiple pregnancy |
|
| D |
Hydramnios |
Hydramnios
The danger of internal podalic version in obstructed labour is :
| A |
Perineal tear |
|
| B |
Cervical tear |
|
| C |
Rupture of lower uterine segment |
|
| D |
Rupture of upper uterine segment |
Rupture of lower uterine segment
|
Features |
Upper uterine segment |
Lower uterine segment |
|
Anatomical position |
Upper uterine part |
It is formed from the uterine Dart between anatomical internal os and histological internal os during labour |
|
During labour |
:Active segment; contracts, retracts, and expels the fetus. |
Relatively passive segment dilate and form greatly expanded , thinned out tube through which the foetus can pass |
|
Thickness during contraction |
Becomes progressively thickened |
Becomes progressively thinned |
|
Consistency during contraction |
Firm |
Soft |
|
Peritoneal attachment |
Firm |
Loose |
|
Retractile property |
Good |
Poor |
|
Placental attachment |
Left Lateral wall or upper segment |
Placenta previa |
| A | Pudendal block | |
| B |
IV calmpose |
|
| C |
Spinal |
|
| D |
General |
General
Incorrect about external cephalic version is :
| A |
Done at 34 week |
|
| B |
Abruption of placenta is a complication |
|
| C |
Done under general anesthesia |
|
| D |
All |
All
Only indication for internal version nowadays is:
| A |
Brow presentation |
|
| B |
Face presentation |
|
| C |
Second fetus of twins |
|
| D |
Breech |
Second fetus of twins
External cephalic version is contraindicated in all except:
| A |
Breech |
|
| B |
Twins |
|
| C |
Placenta previa |
|
| D |
Previous |
Breech
The complication that can occur with internal podalic version for transverse lie is :
| A |
Uterine rupture |
|
| B |
Uterine atony |
|
| C |
Cervical laceration |
|
| D |
Vaginal laceration |
Ans. is a i.e. Uterine rupture
Internal Podalic Version is done in case of transverse lie / oblique lie after deeply anaesthetizing the patient, by introducing the hand in uterine cavity and turning the fetus manually so that it becomes breech presentation. The only indication of ;ntemal podalic version in modern day obstetrics is delivery of second twin. This procedure has been abandoned because of the high incidence of uterine rupture associated with it.
Hazards of Internal Podal°
|
Maternal risk Placental abruption Rupture of the uterus Increased morbidity |
Fetal risk Asphyxia Cord prolapse Intracranial haemorrage, fetal trauma (and hazards of breech delivery) |
September 2012
| A | Primigravida | |
| B |
Flexed breech |
|
| C |
Anemia |
|
| D |
PIH |
Ans. D i.e. PIH
External version
- Conversion is done by External manipulation only
- Done for Breech presentation and Transverse lie.
Internal version
- Done in Transverse lie in case of second baby of twins.
- Conversion is done by one hand introduced into the uterus and the other on the abdomen
September 2006
| A | Elective caesarean section | |
| B |
External cephalic version followed by vaginal delivery |
|
| C |
Trial of labour |
|
| D |
External cephalic version followed caesarean section |
Ans. B: External cephalic version followed by vaginal delivery
Indications for Elective caesarean section in breech presentation:
- Estimated fetal weight more than 3.5 kg
- Hyperextended head
- Footling presentation
- Associated complications
- Pelvic inadequacy
Otherwise try external cephalic version and trial of vaginal breech delivery.
Ideal management of 37 weeks uncomplicated breech pregnancy is:
March 2010
| A | Spontaneous vaginal delivery | |
| B | Elective caesarean section | |
| C |
External cephalic version and trial of vaginal delivery |
|
| D |
None |
Ans. C: External cephalic version and trial of vaginal delivery
Indications for Elective caesarean section in breech presentation:
- Estimated fetal weight more than 3.5 kg
- Hyperextended head
- Footling presentation
- Associated complications
- Pelvic inadequacy

