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The majority of fetuses are in a breech presentation early in pregnancy. By week 38th week of gestation, however, the fetus normally turns to a cephalic presentation. Although the fetal head is the widest single diameter, the fetus’s buttocks [ breech], plus the lower extremities, actually takes up more space. The fundus, being the largest part of the uterus, probably accounts for the fact that in approximately 97% of all pregnancies, the fetus turns so that the buttocks and lower extremities are in the fundus. Vaginal delivery of a breech presentation requires great skill if the fetus is not to be damaged. With the low rate of vaginal breech deliveries in the developed world, experience is being lost. 6% of women with breech presentation still have a vaginal breech delivery as they present too late - so units need to retain a high level of preparedness. Types of breech presentation: I. Complete breech [ flexed breech]: The fetal attitude is one of complete flexion, with hips and knees both flexed and the feet tucked in beside the buttocks. The presenting part consists of two buttocks, external genitalia and two feet. It is commonly present in multiparae. II. Incomplete breech: This is due to varying degrees of extension of thighs or legs at podalic pole. Three varieties are possible; - Breech with extended legs [ frank breech ]: The breech presents with the hips flexed and legs extended on the abdomen. 70% of breech presentations are of this type and it is particularly common in primigravidae whose good uterine muscle tone inhibits flexion of the legs and free turning of the fetus. - Footling breech: This is rare. One or both feet present because neither hips nor knees are fully flexed. The feet are lower than the buttocks, which distinguishes it from the complete breech. - Knee presentation: This is very rare. Thighs are extended but the knees are flexed, bringing the knees down to present at the brim.
Dr. Samir Abd Elghaffar, Associate professor of Intervetional Radiology at Ain Shams University , Faculty of Medicine is being interviewed and showing a case of a patient who has been successfully treated from Hepatocellular Carcinoma HCC by Radio Frequency Ablation RFA on the the famous satellite channel MBC.
الأستاذ الدكتور سمير عبد الغفار أستاذ الاشعة التداخلية في كلية الطب جامعة عين شمس يظهر في برنامج التفاح الأخضر على قناة ال ام بي سي ليبشر مرضى سرطان الكبد بالعلاج الجديد بالتردد الحراري مع احد المرضى
These Tampa Thigh Liposuction before and after photos show the work of renowned liposculpting surgeon Dr. Thomas Su. Dr. Su, of the Artistic Liposculpting Center specializes in body contouring procedures like leg liposuction. Thigh lipo is perhaps one of the most cosmetically rewarding liposuction procedures as it enhances the patient’s overall shape and contour. To learn more about leg and thigh lipo in Tampa, please visit http://www.artlipo.com/leg-liposuction-in-tampa-bay.html
The etiology of BOO is diverse and definitely gender specific. Often anatomic causes induce functional abnormality that remains somewhat unique for each individual, regardless of sex. A full appreciation of the possible etiologies of obstruction is necessary in order to identify overt and more subtle scenarios. In women, iatrogenic causes of obstruction are the most common. Other entities account for far fewer of the cases. The obstruction evaluation in women is somewhat more diverse in terms of modalities used, with no single grouping of techniques that are generally apropos. Individualized evaluation remains a tenet of analysis, and urodynamic criteria used to diagnose BOO in women continue to evolve.
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