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Breech delivery — DIPIMC MCQ

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HardPaediatric and Obstetric EmergenciesBreech deliveryDIPIMCDipIMC

A multiparous woman has an unplanned breech birth progressing spontaneously; the buttocks, trunk and legs have delivered without delay and fetal tone remains good. What approach should the attending clinician take next?

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

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Correct answer: B — Support the trunk gently and allow spontaneous delivery to progress

The best answer is “Support the trunk gently and allow spontaneous delivery to progress”. When an unexpected breech birth is progressing normally, a largely hands-off approach avoids provoking arm or head extension. Support the delivered body and maintain warmth without traction, while preparing recognised manoeuvres if progress stops. Pulling, vigorous rotation or fundal pressure can cause injury and head entrapment. The scenario does not yet justify an assisted after-coming-head manoeuvre.

Reference: RCOG Green-top Guideline 20b, Management of breech presentation: https://www.rcog.org.uk/guidance/browse-all-guidance/green-top-guidelines/management-of-breech-presentation-green-top-guideline-no-20b/