Malpresentation

Question 1

What are the types of breech presentations?

Answer 1

The three types of breech presentations are:

Frank Breech: Hips flexed, knees extended (feet near the head).
Complete Breech: Both hips and knees are flexed.
Footling Breech: One or both feet are presenting first.

Question 2

What is the preferred management of breech presentation at term?

Answer 2

External cephalic version (ECV) at 36-37 weeks, followed by planned cesarean delivery if ECV is unsuccessful or contraindicated

Question 3

What is an occiput posterior position?

Answer 3

The occiput posterior (OP) position is when the baby’s head is down, but the back of the head is toward the mother’s back, leading to a more difficult and prolonged labor.

Question 4

What are the management options for occiput posterior position during labor?

Answer 4

Management may include:

Maternal positioning (e.g., hands and knees).
Manual rotation of the fetus.
Operative delivery if labor does not progress.

Question 5

What is a transverse lie?

Answer 5

In a transverse lie, the fetus is positioned horizontally in the uterus, with its head on one side and its buttocks on the other, making vaginal delivery impossible.

Question 6

How is a transverse lie managed?

Answer 6

Transverse lie is managed by external cephalic version if detected before labor or by cesarean delivery if labor has started or if the version is unsuccessful.

Question 7

What is a brow presentation?

Answer 7

Brow presentation occurs when the fetal head is partially extended, with the brow (forehead) as the presenting part.

Question 8

What is the management of brow presentation?

Answer 8

Brow presentation often requires cesarean delivery as the presenting diameter is too large for vaginal delivery.

Question 9

What is a face presentation?

Answer 9

Face presentation occurs when the fetal head is fully extended, and the face is the presenting part.

Question 10

How is face presentation managed?

Answer 10

If the chin is anterior (mentoanterior), vaginal delivery may be possible; otherwise, cesarean delivery is often required.

Question 11

What is the occiput transverse position?

Answer 11

Occiput transverse position occurs when the fetal head is down, but the occiput is directed toward the mother’s side (right or left), which may cause arrest in the second stage of labor.

Question 12

What is the biparietal diameter (BPD)?

Answer 12

The biparietal diameter is the distance between the two parietal bones of the fetal skull. It is approximately 9.5 cm at term and is the widest transverse diameter of the fetal head.

Question 13

What is the suboccipitobregmatic diameter?

Answer 13

The suboccipitobregmatic diameter is the distance from the undersurface of the occiput (just above the nape of the neck) to the center of the bregma (anterior fontanelle). It measures about 9.5 cm and is the presenting diameter when the fetal head is fully flexed.

Question 14

What is the occipitofrontal diameter?

Answer 14

The occipitofrontal diameter is the distance from the occipital protuberance to the glabella (the smooth area between the eyebrows). It measures about 11.5 cm and is the presenting diameter in a deflexed head.

Question 15

What is the mentovertical diameter?

Answer 15

The mentovertical diameter is the distance from the chin (mentum) to the highest point of the vertex. It measures about 13.5 cm and is the presenting diameter in a brow presentation.

Question 16

What is the submentobregmatic diameter?

Answer 16

The submentobregmatic diameter is the distance from the point where the chin (mentum) meets the neck to the center of the bregma. It measures about 9.5 cm and is the presenting diameter in a face presentation when the head is fully extended.

Question 17

What is the suboccipitofrontal diameter?

Answer 17

The suboccipitofrontal diameter is the distance from the nape of the neck (suboccipital region) to the midpoint of the forehead (frontal region). It measures about 10.5 cm and is the presenting diameter when the head is partially flexed.

Question 18

What is the fronto-occipital diameter?

Answer 18

The fronto-occipital diameter is the distance from the forehead (frons) to the occiput. It measures about 12 cm and represents a larger diameter that may present in cases of abnormal head position during labor.

Question 19

What are the four main types of female pelvises? A: The four main types of female pelvises are:

Answer 19

Gynecoid
Android
Anthropoid
Platypelloid

Question 20

What are the characteristics of a Gynecoid pelvis?

Answer 20

A Gynecoid pelvis is the most common type, with:

Rounded pelvic inlet
Wide subpubic arch
Non-prominent ischial spines
Suitable for vaginal delivery

Question 21

What are the characteristics of an Android pelvis?

Answer 21

An Anthropoid pelvis is oval-shaped, with:

Long anteroposterior diameter
Narrow transverse diameter
Wide sacrum
Often favorable for vaginal delivery, but may result in occiput posterior position

Question 22

What are the characteristics of a Platypelloid pelvis?

Answer 22

A Platypelloid pelvis is flat and broad, with:

Wide transverse diameter
Short anteroposterior diameter
Shallow pelvic cavity
Often associated with transverse fetal positions and may require cesarean delivery

Question 23

Which pelvic type is most favorable for vaginal delivery?

Answer 23

The Gynecoid pelvis is the most favorable type for vaginal delivery due to its rounded shape and spacious dimensions.

Question 24

Which pelvic type is least common and most associated with delivery complications?

Answer 24

The Platypelloid pelvis is the least common type and is often associated with delivery complications due to its flattened shape and narrow anteroposterior diameter.

Question 25

What is the true conjugate (anatomical conjugate) diameter?

Answer 25

The true conjugate, also known as the anatomical conjugate, is the distance between the sacral promontory and the upper border of the pubic symphysis. It measures approximately 11 cm and is crucial for assessing the adequacy of the pelvic inlet.

Question 26

What is the obstetric conjugate diameter?

Answer 26

The obstetric conjugate is the shortest distance between the sacral promontory and the thickest part of the pubic symphysis. It is usually about 10.5 cm and is the most critical measurement for determining if the fetal head can pass through the pelvic inlet.

Question 27

What is the diagonal conjugate diameter?

Answer 27

The diagonal conjugate is the distance from the lower border of the pubic symphysis to the sacral promontory. It can be measured manually and is typically 12.5 cm. It helps in estimating the obstetric conjugate.

Question 28

What is the transverse diameter of the pelvic inlet?

Answer 28

The transverse diameter of the pelvic inlet is the widest distance across the pelvic brim, measured between the farthest points on the iliopectineal lines. It is approximately 13 cm.

Question 29

What is the interspinous diameter?

Answer 29

The interspinous diameter is the distance between the ischial spines, usually the narrowest part of the pelvic cavity. It measures about 10.5 cm and is critical for the engagement of the fetal head during labor.

Question 30

What is the bituberous diameter (intertuberous diameter)?

Answer 30

The bituberous diameter, or intertuberous diameter, is the distance between the inner edges of the ischial tuberosities. It typically measures around 11 cm and is important for assessing the pelvic outlet.

Question 31

What is the sacrococcygeal diameter?

Answer 31

The sacrococcygeal diameter is the distance from the lower end of the sacrum to the lower border of the pubic symphysis. It varies depending on the flexibility of the coccyx but generally measures around 9.5 cm.

Question 32

What is the anterior-posterior diameter of the pelvic outlet?

Answer 32

The anterior-posterior diameter of the pelvic outlet is the distance from the lower border of the pubic symphysis to the tip of the sacrum. It measures about 11.5 cm and is important for the final stage of labor when the fetal head is crowning.