Presentation (obstetrics)

In obstetrics, the presentation of a fetus about to be born specifies which anatomical part of the fetus is leading, that is, is closest to the pelvic inlet of the birth canal. According to the leading part, this is identified as a cephalic, breech, or shoulder presentation. A malpresentation is any presentation other than a vertex presentation (with the top of the head first).

YouTube Encyclopedic

1/3
Views:
11 414
66 197
1 170 647

Transcription

Classification

Thus the various presentations are:

cephalic presentation (head first):
- vertex (crown)—the most common and associated with the fewest complications
- sinciput (forehead)
- brow (eyebrows)
- face
- chin
breech presentation^[1] (buttocks or feet first):
- complete breech
- footling breech
- frank breech
shoulder presentation:
- arm
- shoulder
- trunk
compound presentation—when any other part presents along with the fetal head

Related obstetrical terms

Attitude

Definition: Relationship of fetal head to spine:
- flexed, (this is the normal situation)
- neutral ("military"),
- extended.
- hyperextended

Position

Relationship of presenting part to maternal pelvis based on presentation. The fetus enters the pelvis in the occipito-transverse plane (left or right), descent, and flexion and then rotates 90 degrees to the occipitoanterior (most commonly).
- Cephalic presentation
  - Vertex presentation with longitudinal lie:^[1]
    - Left occipitoanterior (LOA)—the occiput is close to the vagina (hence known as vertex presentation), facing anteriorly (forward with mother standing) and toward the left. This is the most common position and lie.
    - Right occipitoanterior (ROA)—the occiput faces anteriorly and toward the right. Less common than LOA, but not associated with labor complications.
    - Left occipitoposterior (LOP)—the occiput faces posteriorly (behind) and toward the left.
    - Right occipitoposterior (ROP)—the occiput faces posteriorly and toward the right.
    - Occipitoanterior—the occiput faces anteriorly (absolutely straight without any turning to any of the sides)
    - Occipitoposterior—the occiput faces posteriorly (absolutely straight without any turning to any of the sides)
  - Face presentation
    - Mentum anterior—the fetal chin is in the direction of the maternal pubic symphysis.
    - Mentum posterior—the fetal chin is in the direction of the maternal sacrum. This presentation is not compatible with vaginal delivery.^[why?]
- Breech presentation with longitudinal lie:^[1]
  - Left sacrum anterior (LSA)—the buttocks, as against the occiput of the vertex presentation, lie close to the vagina (hence known as breech presentation), which lie anteriorly and toward the left.
  - Right sacrum anterior (RSA)—the buttocks face anteriorly and toward the right.
  - Left sacrum posterior (LSP)—the buttocks face posteriorly and toward the left.
  - Right sacrum posterior (RSP)—the buttocks face posteriorly and toward the right.
  - Sacrum anterior (SA)—the buttocks face anteriorly.
  - Sacrum posterior (SP)—the buttocks face posteriorly.
- Shoulder presentations with transverse lie are classified into four types, based on the location of the scapula (shoulder blade). This presentation needs to be delivered by cesarean section.
  - Left scapula-anterior (LSA)
  - Right scapula-anterior (RSA)
  - Left scapula-posterior (LSP)
  - Right scapula-posterior (RSP)

Lie

Definition: Relationship between the longitudinal axis of fetus and mother:
- longitudinal (resulting in either cephalic or breech presentation)
- oblique (unstable, will eventually become either transverse or longitudinal)
- transverse (resulting in shoulder presentation)
  - back up
  - back down (indication for vertical uterine incision during cesarean delivery)

References

^ ^a ^b ^c Kish, Karen; Joseph V. Collea (2003). "Malpresentation & Cord Prolapse (Chapter 21)". In Alan H. DeCherney (ed.). Current Obstetric & Gynecologic Diagnosis & Treatment. Lauren Nathan (Ninth ed.). Lange/McGraw-Hill. p. 369. ISBN 0-07-118207-1.

External links

Pregnancy and childbirth

Planning

Conception

Testing

Types

Childbirth

Preparation	Bradley method Hypnobirthing Lamaze Nesting instinct
Roles	Mother Newborn Preterm birth Postterm pregnancy Doula Birth attendant Men's roles Midwife Auxiliary nurse midwife Obstetrician Perinatal nurse Traditional birth attendant
Delivery	Pelvimetry / Bishop score cervical dilation cervical effacement position Bloody show Uterine contraction Vaginal delivery Presentation breech cephalic shoulder Rupture of membranes Caesarean Childbirth positions Home birth Labor induction Multiple birth Natural childbirth Silent birth Unassisted childbirth Water birth Placental expulsion

Prenatal

Anatomy	Amniotic fluid Amniotic sac Endometrium Placenta
Development	Fetus Fundal height Gestational age Human embryogenesis Maternal physiological changes Postpartum physiological changes
Care	Brain health and pollution Nutrition environmental toxicants in pregnancy prenatal Prenatal depression Immunization Concomitant conditions Anemia Hypertension Hypercoagulability Substance use Smoking Alcohol Cannabis Opioids Endocrine diseases Diabetes Thyroid disease Liver diseases Acute fatty liver Intrahepatic cholestasis Infections HIV COVID-19 Hepatitis C Malaria Skin diseases Lupus Pruritic folliculitis Dermatoses Others Drugs Vaginal flora Bleeding Motor vehicle emissions Pre-existing disease Sleep
Procedures	Amniocentesis Cardiotocography Chorionic villus sampling Nonstress test Abortion

Postpartum

Maternal	Lochia Postpartum care Postpartum depression Postpartum confinement Sex after pregnancy Psychiatric disorders of childbirth Postpartum physiological changes
Roles	Doula Health visitor Lactation consultant Monthly nurse Confinement nanny
Infant	Adaptation to extrauterine life Apgar score Child care Congenital disorders

Obstetric history

Gravidity and parity

This page was last edited on 2 May 2023, at 17:34

From Wikipedia, the free encyclopedia