Chapter 22: Normal Labor (skeleton) Flashcards
Define and give types Lie Presentation Attitude Position
Lie
- fetal long xis with respect to the birth canal/to that of the mother
- transverse, oblique, longitudinal
Presentation
- fetal body part either foremost within the birth canal or in close proximity to it
- cephalic (face, sinciput, brow, occiput/vertex), breech, shoulder
Attitude
Position
fetal and maternal axes cross at 45deg angles, this lie is unstable
oblique
Presentation:
head is flexed sharply, the chin connects th thorax; occiput is the presenting part
vertex/occiput
vertex/occiput presentation
head is flexed sharply, the chin connects th thorax; occiput is the presenting part
Presentation:
fetal neck sharply extended, occiput and back come into contact
face presentation
face presentation
Presentation:
fetal neck sharply extended, occiput and back come into contact
Presentation:
neck partially extended
brow presentation
brow presentation
neck partially extended
Presentation:
neck partly flexed, anterior fontanel present
sinciput presentation
sinciput presentation
neck partly flexed, anterior fontanel present
Why does the fetus usually assume the vertex position
uterus is pyriform, the entire podalic pole (breech + extremities) of the fetus is bulkier and more mobile than the cephalic pole
Describe the characteristic fetal posture/attitude
- folded upon itself - convex back
- head is sharply flexed
- chin in contact with chest
- thighs flexed
- legs bent at knees
- arms across thorax or at sides
- umbilical cord in the space between extremities
Determining point of each presentation: vertex breech face shoulder
vertex - occiput
breech - sacrum
face - mentum
shoulder - acromion
Leopold Maneuvers
1st: Fundal
- assess fetal lie
- breech: large nodular mass; head: hard, round, ballottable
2nd: Umbilical
- assess orientation
- fetal back vs small parts
3rd: Pelvic 2/Pawlik’s
- confirms presentation
4th: Pelvic 1
- degree of descent
- examiner faces mother’s feet
TRUE or FALSE
the fetus enters the pelvis more commonly in the ROT position
FALSE. LOT