face brow shoulder Flashcards
What are the causes of face presentation?
Complete extension of fetal head
1- fetal anomaly
2- thyroid tumor
3- anencephalic babies
4- preterm babies
5- high parity
6- increased tone of extensor muscles
7- cephalopelvic disproportion
How is a baby in mento anterior presentation delivered?
Mentum is directly under the symphysis pubis
- presenting diameter is submento-bregmatic = 9.5cm
Leads to poor progress in labour -> head is delivered in flexion
What can be used to assist mento anterior labour?
- fetal heart monitoring ONLY through external devices
- ventouse is CONTRAINDICATED
- only LOW or OUTLET forceps can be used
How is a baby in mento posterior presentation delivered?
Mentum is posterior towards sacrum -> presenting part is too large to be delivered
1- wait until full dilatation for spontaneous rotation to mento anterior
2- if mento posterior persists -> C section
What are the complications of face presentation?
1- labour prolongation
2- increased risk for instrumental delivery & C section
3- cord prolapse
4- facial edema
What is the presenting diameter in brow presentation?
Mento-vertical = 13.5
Due to deflexed neck
What are the causes of brow presentation?
1- multiparity
2- prematurity
3- cephalopelvic disproportion
How is brow presentation diagnosed?
Feeling anterior fontanelle & supraorbital ridges
- denominator is frontal bone
How is a baby is brow presentation delivered?
Should be transient &changes to other presentation by full dilatation -> if it persists C section
What are the causes of shoulder presentation?
Transverse lie due to
1- placenta Previa
2- multiparity
3- pelvic tumor, contracted pelvis, & uterine anomaly
4- preterm fetuses
5- polyhydramnios
How is shoulder presentation managed?
- if ANTENATAL -> external cephalic version can be tried
- if INTRAPARTUM -> C section
Vaginal delivery may cause uterine rupture
Associated with cord prolapse
How is compound presentation managed?
1- observe -> prolapsed part doesn’t interfere with labour & retracts with descent of presenting part
2- if not retracted -> push upwards or pinch so it retracts
