Problems with Fetal Position, Presentation, or Size Flashcards
During internal rotation, the fetal head must rotate not through a 90-degree arc but through an arc of approximately 135-degrees
Occipitoposterior position
Positions for patients that can aid from a posterior position
- Hands-and-Knees position
- Squatting
- Lying on their side
If mother lying on her left side, the fetal position is
ROP (Right Occiput Posterior)
If mother lying on her right side, the fetal position is
LOP (Left Occiput Posterior)
Rationale of patients choosing epidurals for their deliveries and peanut ball placed between the legs
- Open the pelvis
- Reduce total labor time
Posterior positions tend to occur in birthing parents with
- Andriod pelvis
- Anthropoid pelvis
- Contracted pelvis
Posterior positions tend to occur in birthing parents with: Android pelvis, Anthropoid pelvis, and/or Contracted pelvis. These positioning is suggested by a
Dysfunctional labor
Having a posteriorly presenting fetal head can be confirmed by what diagnostic tests?
- Vaginal examinations
- Ultrasound
A posteriorly presenting fetal head does not fit the cervix as snugly as one in an anterior position - this increases the risk of having _____________
Risk of umbilical cord prolapse
Because the fetal head rotates against the sacrum, a birthing parent may experience pain and pressure at what area of the back?
May experience pressure and pain in their lower back
Because the fetal head rotates against the sacrum, a birthing parent may experience pain and pressure in their lower back because ______________
Sacral nerve compression
Management for having pressure and pain in the lower back during an Occipitoposterior Position
- Applying counterpressure on the sacrum by a back rub
- Rebozo method
What method that is being used for the management for pressure and lower back pain where jiggling massaging the uterus may be helpful when assisting the fetus to rotate into a better position
Rebozo method
It is a more hazardous fetal presentation
Breech position
It occurs because of cervical pressure on the buttocks and rectum
Meconium staining
__________ can lead to meconium aspiration if the infant inhales AF
Meconium excretion
Assessment of Breech position
Where can you usually hear the FHR?
High in the abdomen
Diagnostic procedures to detect Breech positioning
- Vaginal examination
- Leopold’s Maneuver
If the breech position is unclear, what diagnostic test should be done?
Ultrasound
Management of Breech position
Always monitor FHR and uterine contractions
When monitoring the FHR and uterine contractions as management for Breech position, what conditions that can be detected early?
- Cord prolapse
- Arrest of descent
True or False: birthing of the head during a breech position is the most hazardous part
True
What is the considered second danger of having a breech presentation?
Intracranial hemorrhage
Causes of Breech position
- Gestational age less than 37 weeks
- Abnormality of the fetus
- Polyhydramnios
- Congenital anomalies of the uterus
- Any space-occupying mass in the pelvis
- Pendulous abdomen
- Multiple gestation
- Pelvic diameters
- Fetal skull diameters
- Evidence of possible placenta previa
A fetal head presenting at a different angle than expected is termed ____________
Asynclitism
________ is rare but when it does, the head diameter of the fetus presents to the pelvis is often too large for birth to proceed
Face (chin or mentum)
Face presentation can be confirmed by ______
Vaginal examination
Ultrasound
Face presentation
If the chin is anterior and the pelvic diameters are within normal limits, it may be possible for the infant to ___________
To be born without any difficulty or NSD
Face presentation
If the chin is posterior
CS is the method of choice
Babies born after a face presentation have a great deal of ___________ and may be purple from ecchymotic bruising
Facial edema
One of the rarest fetal presentations
Brow presentation
Brow presentation occurs in patients with
- Multiparity
- Relaxed abdomen muscles
