abnormal fetal positions Flashcards
what is OP
occiput in one of the posterior segments of the pelvis. post fontanelle
why is labour prolonged in OP position
degree of rotation needed
what happens to baby during labour OP
60% rotate to OA,some to transverse and arrest and some to truly posterior
what is the commonest malpresentation
breech
conditions pre disposing to breech
contracted pelvis, bicornuate uterus, fibroid uterus, oligohydramnios, placenta praevia, spina bifida, hydrocephalic fetus
what can women complain of if breech
pain under their ribs
main causes of morbidity breech
intracranial haemorrhage, asphyxia, fracture of clavicle femur humerus
what is the commonest type of breech
frank- extended legs
types of breech
frank (extended legs), complete (flexed legs), footling
which type of breech has the highest risk of cord prolapse
footling
management breech if vaginal delivery planned
external cephalic version- 36 weeks primip, 37 weeks multip
contraindications cephalic version
placenta praevia, ruptured membranes, APH in last 7 days, multiple pregnancy, uterine scars, fetal abnormality, pre eclampsia, unstable lie
contraindications vaginal delivery in breech
footling, kneeling breech, inadequate pelvis, prev c section, hyperextended neck, concomitant condition
what leads to a face delivery
most by chance- head extends rather than flexes as engages, 15% due to congenital malformation eg anencephaly
what is the most unfavourable presentation
brow
