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Breech birth imminent — DipIMC MCQ

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HardPaediatric and Obstetric EmergenciesBreech birth imminentDipIMC

A multiparous woman at 39 weeks is found at home with fetal buttocks visible and the next contraction starting. Transport time to hospital is 25 minutes. What is the most appropriate management?

Educational content. Not a substitute for clinical judgement or local policy.

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Correct answer: E — Prepare for birth, avoid pulling the baby and request midwifery or obstetric support

Prepare for birth, avoid pulling the baby and request midwifery or obstetric support is the best answer because an imminent breech birth should be managed gently without traction while expert help is summoned. Provide reassurance and reassess after transport is less appropriate because reassurance is inadequate for an evolving major trauma problem; Immobilise every joint and delay departure for a detailed examination is less appropriate because prolonged packaging can delay definitive care. Use oral analgesia as the main treatment and Defer treatment until a senior hospital doctor reviews the patient are also suboptimal because they move attention away from the key pre-hospital priority.. The key DipIMC principle is to treat immediate reversible threats, communicate clearly and move the patient toward the right definitive care.

Reference: JRCALC Guidelines; RCOG Breech guidance