Footling Breech

Figure 4.34. The characteristic molding of the head of an infant in a breech presentation. The frontal view shows the occipitofrontal head elongation along with a prominent occipital shelf and the neck appears long.

Occipital Shelf Newborn

Figure 4.35. Lateral view of the head of the same infant shows the flattening of the vertex and the prominent occipital shelf. The plane of flattening is directed upward and forward from the occipital protuberance, which is quite prominent. The characteristic head results from prolonged pressure of the flexed head against the fundus of the uterus in breech presentation.

4.35

Figure 4.35. Lateral view of the head of the same infant shows the flattening of the vertex and the prominent occipital shelf. The plane of flattening is directed upward and forward from the occipital protuberance, which is quite prominent. The characteristic head results from prolonged pressure of the flexed head against the fundus of the uterus in breech presentation.

Footling Breech Presentation

Figure 4.36. "Hanging neck" contusion in a difficult delivery of a breech presentation. The infant was extremely depressed and required ventilatory support.

4.36

Double Footling Breech

4.37

Double Footling Breech
Figure 4.37. Double footling breech presentation. The right leg presented through the cervical os for 6 hours prior to delivery. Note the marked ecchymoses and edema. This resolved spontaneously but the infant developed hyperbilirubinemia.

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