face brow shoulder Flashcards

1
Q

What are the causes of face presentation?

A

Complete extension of fetal head
1- fetal anomaly
2- thyroid tumor
3- anencephalic babies
4- preterm babies
5- high parity
6- increased tone of extensor muscles
7- cephalopelvic disproportion

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2
Q

How is a baby in mento anterior presentation delivered?

A

Mentum is directly under the symphysis pubis
- presenting diameter is submento-bregmatic = 9.5cm

Leads to poor progress in labour -> head is delivered in flexion

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3
Q

What can be used to assist mento anterior labour?

A
  • fetal heart monitoring ONLY through external devices
  • ventouse is CONTRAINDICATED
  • only LOW or OUTLET forceps can be used
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4
Q

How is a baby in mento posterior presentation delivered?

A

Mentum is posterior towards sacrum -> presenting part is too large to be delivered

1- wait until full dilatation for spontaneous rotation to mento anterior
2- if mento posterior persists -> C section

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5
Q

What are the complications of face presentation?

A

1- labour prolongation
2- increased risk for instrumental delivery & C section
3- cord prolapse
4- facial edema

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6
Q

What is the presenting diameter in brow presentation?

A

Mento-vertical = 13.5

Due to deflexed neck

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7
Q

What are the causes of brow presentation?

A

1- multiparity
2- prematurity
3- cephalopelvic disproportion

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8
Q

How is brow presentation diagnosed?

A

Feeling anterior fontanelle & supraorbital ridges
- denominator is frontal bone

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9
Q

How is a baby is brow presentation delivered?

A

Should be transient &changes to other presentation by full dilatation -> if it persists C section

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10
Q

What are the causes of shoulder presentation?

A

Transverse lie due to
1- placenta Previa
2- multiparity
3- pelvic tumor, contracted pelvis, & uterine anomaly
4- preterm fetuses
5- polyhydramnios

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11
Q

How is shoulder presentation managed?

A
  • if ANTENATAL -> external cephalic version can be tried
  • if INTRAPARTUM -> C section

Vaginal delivery may cause uterine rupture
Associated with cord prolapse

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12
Q

How is compound presentation managed?

A

1- observe -> prolapsed part doesn’t interfere with labour & retracts with descent of presenting part
2- if not retracted -> push upwards or pinch so it retracts

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