Mal Position Presentation And Breech Flashcards
Abnormal lie is?
The fetal lie indicates the orientation of the fetal spine relative to the spine of the mother. The normal fetal lie is longitudinal and by itself does not indicate whether the presentation is cephalic or breech.
Abnormal lie complications?
Cord prolapse occurs 20 times as often with abnormal lie as it does with a cephalic presentation.
Mgt of abnormal lie?
External cephalic version (ECV) is recommended at 36 to 37 weeks to help diminish the risk of adverse outcome.
If the lie is transverse or oblique which c/s can be used?
vertical incision (low vertical or classical) may be a reasonable alternative.
Face presentation is?
A face presentation is characterized by a longitudinal lie and full extension of the fetal neck and head with the occiput against the upper back the fetal chin (mentum) is chosen as the point of designation during vaginal examination.
In case of mentum posterior position mgt is by?
Persistence of the mentum posterior position with an infant of normal size, however, makes safe vaginal delivery less likely. Overall, 70% to 80% of infants with a face presenting can be delivered vaginally, either spontaneously or by low forceps in the hands of a skilled operator,
Mentum anterior management?
descent, internal rotation generally to a mentum anterior position, and delivery by flexion as the chin passes under the symphysis
Brow presentation
A fetus in a brow presentation occupies a longitudinal axis with a partially deflexed cephalic attitude midway between full flexion and full extension The frontal bones are the point of designati
Progress of brow presentation
Most brow presentations convert spontaneously by flexion or further extension to either a vertex or a face presentation and are then managed accordingly.
Compound presentation
Whenever an extremity, most commonly an upper extremity, is found prolapsed beside the main presenting fetal part, the situation is referred to as a compound presentation The combination of an upper extremity and the vertex is the most common
Mgt of compound presentation
C/s
Complications of compound presentation is
Cord prolapse
Before assisted breech delivery things that should be done
1) anesthesia coverage is immediately available, (2) cesarean delivery can be undertaken promptly, (3) continuous FHR monitoring is used, and (4) the delivery is attended by a pediatrician and two obstetricians, of whom at least one is experienced with vaginal breech birth.
Footling breech have a righ risk for
Cord prolapse
High rates of fetal morbidity and mortality are associated with which breech
premature breech
breech with a hyperextended head
the footling breech
For twin breach one the first cephalic use
nitroglycerin 50 to 200 μg intravenously being one of the fastest acting, safest agents in appropriately selected patients.
External cephalic version is done for breech at
36 to 37 weeks’
Shoulder dystocia is
fetal shoulders are obstructed at the level of the pelvic inlet. Shoulder dystocia results from a size discrepancy between the fetal shoulders and the pelvic inlet, which may be absolute or relative, because of malposition.
Common neurologic injury in shoulder dystocia is
Brachial plexus injury and clavicular fracture
A maneuver that is mostly used in delivering shoulder dystocia?
McRoberts maneuver
