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NORMAL LABOUR AND DELIVERY Part 01

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THE FETUS

Fetal Lie

  1. refers to the orientation of the long axis of the fetus with respect to  the long axis of the uterus
    • longitudinal
    • transverse
    • oblique
  2. transverse/oblique often due to uterine anomalies  (C-section if they don”t convert)
Fetal Presentation

  1. refers to the fetal part presenting at pelvic outlet
    • breech (complete, frank, footling)
    • cephalic
      1. vertex
      2. brow
      3. face
      4. sinciput  ( Forehead and above it )
    • shoulder
  2. compound (fetal extremity prolapses along with presenting part)
  3. all except vertex considered malpresentations
Fetal Position

  1. refers to position of fetal occiput in relation to maternal pelvis
    • occiput anterior (OA): commonest presentation (ìnormal")
    • occiput posterior (OP): most rotate spontaneously to OA : may cause prolonged second stage of labour
    • occiput transverse (OT): leads to arrest of dilatation
  2. normally, fetal head enters maternal pelvis and engages in OT position  subsequently rotates to OA position or OP (in a small percentage of cases)



Attitude

  • refers to flexion/extension of fetal head relative to shoulders
    1. brow presentation : head partially extended (requires C-section)
    2. face presentation: head fully extended (mentum posterior always requires C-section, mentum anterior will deliver vaginally)
Station

  • defined by position of presenting part relative to ischial spines
@ ischial spines = station 0 = engaged

THE CERVIX
  1. Dilatation

    • latent phase: 0-3 cm
    • active phase: 4-10 cm

  2. Effacement :  thinning of the cervix (25%-50%-100%)
  3. Consistency

    • soft vs. hard position
    • posterior vs. anterior

  4. Application : contact between the cervix and presenting part
NORMAL LABOUR AND DELIVERY Part 01 NORMAL LABOUR AND DELIVERY Part 01 Reviewed by Radiology Madeeasy on January 13, 2011 Rating: 5
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