obstruction, malpresentation and malposition Flashcards
When the fetal skull is properly flexed, the suboccipitobregmatic diameter presenting to the pelvis averages how many cm for term infants?
9.5 cm
Risk factors for breech position?
- Breech delivery
- Uterine anomalies
- Hydrocephaly/anencephaly
- PPPROM
- oligohydramnios/polyhydramnios
What can persistent breech presentation cause?
Placenta previa, fetal anomalies, prolapsed cord and entrapment of the head
Explain the different types of breech:
Frank: flexed hips and extended knees, so feet are near head.
Complete: flexed hips but one or both knees are flexed as well, with at least one foot near the breech.
Incomplete or footling: one or both hips not flexed so that the foot or knee lies below breech in birth canal.
How to diagnose breech position?
Leopold maneveurs, vaginal examination and ultrasound.
How to treat breech?
external cephalic version of breech or elective cesarean delivery.
The risk of asphyxia and traumatic injury is higher in what kind of delivery way for breech?
higher for vaginal delivery
What are the contraindication for vaginal delivery in case of breech?
- nulliparity
- Birth weight above 3800g
- incomplete breech
What is the only facial presentation that will allow for vaginal delivery?
Mentum anterior
What is compound presentation?
A fetal extremity presenting alongside the vertex or breech is considered a compound presentation.
What is the fetal position that makes the fetal head pass through the pelvis?
Occiput anterior
What is the most common position of fetus at onset of labor and in second stage of labor?
left or right occiput transverse are common at onset, and then the cardinal movement of internal rotation ususally converts the fetus to the Occiput anterior.
