Breech birth — DipIMC MCQ

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EasyPaediatric and Obstetric EmergenciesBreech birthDipIMC

A woman in advanced labour delivers the baby’s buttocks in the ambulance. The legs and body are delivering spontaneously. What is the most appropriate management?

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Correct answer: E — Support spontaneous delivery and avoid traction

Explanation lettering: C = shown as B · B = shown as C · E = shown as D · D = shown as E

D is correct: In breech delivery, unnecessary traction can trap the head or injure the baby; skilled support and urgent help are needed. A is less suitable because it does not address the discriminator in the vignette; B is less suitable because analgesia is important but does not replace the first physiological intervention; C is less suitable because it does not address the discriminator in the vignette; E is less suitable because it does not address the discriminator in the vignette. The most tempting alternative is therefore suboptimal because it either delays the time-critical pre-hospital intervention or sends the patient to the wrong level of care. The key DipIMC principle is focused cABCDE decision-making with early pre-alert, triage or retrieval escalation when the scene physiology demands it.

Reference: JRCALC Guidelines; Resuscitation Council UK Paediatric and Newborn Guidelines; NICE NG39