Malpresentations Flashcards
(20 cards)
Commonest fetal presentation
Cephalic
Commonest fetal position?
Left occiputo-anterior
Attitude is the position of fetal parts, what’s the commonest
Flexion attitude
What does Fetal Engagement mean?
How far the head is, relative to the ischial spine. As such Engagment 0 means, the head is at the ischial spine.
What is the diameter of the female pelvis then?
12 by 13cm, oblique 12 transverse 13
What is the engaging diameter when the baby presents Chin anterior (meno anterior)
9.5cm
What is the engaging diameter, when the baby presents as chin posterior (mento posterior)
11.5cm
What difference does mento anterior or posterior make?
If posterior, we deliver via C-section, however anterior means we can deliver vaginally
But what if a baby presents mento vertical? (13.5cm)
Delivered via C section aswell
Commonest type of breech presentation?
Frank breech.
What is an External Cephalic Version (ECV) and what is it used for?
To turn a breech baby position, to a face-first position
Explain the Mauriceau-smellie veit manoeuvre?
Jaw flexion and shoulder traction to deliver the head
What does loveset’s manoeuvre do?
Deliver the shoulders
What is the burns-Marshall manoeuvre?
Letting him hang, freeing his mouth, and swinging his head clear
A patient in labor has a brow presentation. Which fetal skull diameter is engaged, and what is the delivery method?
A) Suboccipitobregmatic (9.5 cm); vaginal delivery
B) Mentovertical (13.5 cm); cesarean section
C) Submentobregmatic (9.5 cm); forceps delivery
D) Occipitofrontal (11 cm); vacuum extraction
Mentovertical
A term patient undergoes ECV for breech presentation. Which medication is typically administered to facilitate the procedure?
A) Oxytocin
B) Nifedipine
C) Magnesium sulfate
D) Misoprostol
Nifedipine
A 30-year-old at 36 weeks has a footling breech. What is the greatest risk during labor?
A) Shoulder dystocia
B) Cord prolapse
C) Uterine rupture
D) Placental abruption
Cord Prolapse
Which of the following is a contraindication to ECV?
A) Oligohydramnios
B) Frank breech
C) Multiparity
D) Gestational age 38 weeks
A
Which factor is most predictive of successful ECV?
A) Nulliparity
B) Posterior placenta
C) Fetal weight >4 kg
D) Maternal obesity
Posterior Placenta
Which pelvic type is most favorable for vaginal breech delivery?
A) Android
B) Anthropoid
C) Gynecoid
D) Platypelloid
Gynecoid
