Chapter 22: Normal Labor (skeleton)

Question 1

Define and give types
Lie
Presentation
Attitude
Position

Answer 1

Lie

• fetal long xis with respect to the birth canal/to that of the mother
• transverse, oblique, longitudinal

Presentation

• fetal body part either foremost within the birth canal or in close proximity to it
• cephalic (face, sinciput, brow, occiput/vertex), breech, shoulder

Attitude

Position

Question 2

fetal and maternal axes cross at 45deg angles, this lie is unstable

Answer 2

oblique

Question 3

Presentation:

head is flexed sharply, the chin connects th thorax; occiput is the presenting part

Answer 3

vertex/occiput

Question 4

vertex/occiput presentation

Answer 4

head is flexed sharply, the chin connects th thorax; occiput is the presenting part

Question 5

Presentation:

fetal neck sharply extended, occiput and back come into contact

Answer 5

face presentation

Question 6

face presentation

Answer 6

Presentation:

fetal neck sharply extended, occiput and back come into contact

Question 7

Presentation:

neck partially extended

Answer 7

brow presentation

Question 8

brow presentation

Answer 8

neck partially extended

Question 9

Presentation:

neck partly flexed, anterior fontanel present

Answer 9

sinciput presentation

Question 10

sinciput presentation

Answer 10

neck partly flexed, anterior fontanel present

Question 11

Why does the fetus usually assume the vertex position

Answer 11

uterus is pyriform, the entire podalic pole (breech + extremities) of the fetus is bulkier and more mobile than the cephalic pole

Question 12

Describe the characteristic fetal posture/attitude

Answer 12

• folded upon itself - convex back
• head is sharply flexed
• chin in contact with chest
• thighs flexed
• legs bent at knees
• arms across thorax or at sides
• umbilical cord in the space between extremities

Question 13

Determining point of each presentation:
vertex
breech
face
shoulder

Answer 13

vertex - occiput
breech - sacrum
face - mentum
shoulder - acromion

Question 14

Leopold Maneuvers

Answer 14

1st: Fundal
- assess fetal lie
- breech: large nodular mass; head: hard, round, ballottable

2nd: Umbilical
- assess orientation
- fetal back vs small parts

3rd: Pelvic 2/Pawlik’s
- confirms presentation

4th: Pelvic 1
- degree of descent
- examiner faces mother’s feet

Question 15

TRUE or FALSE

the fetus enters the pelvis more commonly in the ROT position

Answer 15

FALSE. LOT

Question 16

This is the mechanism by which the BPD assess through the pelvic inlet

Answer 16

Engagement

Question 17

Greatest transverse diameter of the fetal head in an occiput presentation

Answer 17

BPD

Question 18

TRUE OR FALSE

the fetal head usually enters the pelvis either longitudinally or obliquely

Answer 18

FALSE

the fetal head usually enters the pelvis either TRANSVERSELY or obliquely

Question 19

Anterior asynclitism

Answer 19

Sagittal suture approaches the sacral promontory, more of the anterior parietal bone is present

Question 20

posterior asynclitism

Answer 20

Sagittal suture approaches the symphysis pubis, more of the posterior parietal bone is present

Question 21

Sagittal suture approaches the symphysis pubis, more of the posterior parietal bone is present

Answer 21

posterior asynclitism

Question 22

Sagittal suture approaches the sacral promontory, more of the anterior parietal bone is present

Answer 22

Anterior asynclitism