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Lesson 10: Fetal Positions and Adaptations |
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The nursing care you may administer to the laboring patient is included in this lesson by presenting key factors in the relationship of the fetus to the obstetric passageway. You may not actually determine this information, however, it is vital that you have a basic understanding of what the nurse or physician identifies. This information will influence the length of labor, preparations for the delivery room, and the type of complications that may occur. 10-2. KEY TERMS RELATED TO FETAL POSITIONS a. "Lie" of an Infant. Lie refers to the position of the spinal column of the fetus in relation to the spinal column of the mother. There are two types of lie, longitudinal and transverse. Longitudinal indicates that the baby is lying lengthwise in the uterus, with its head or buttocks down. Transverse indicates that the baby is lying crosswise in the uterus.b. Presentation/Presenting Part. Presentation refers to that part of the fetus that is coming through (or attempting to come through) the pelvis first.
Figure 10-1. Typical types of presentations.
c. Attitude. This is the degree of flexion of the fetus body parts (body, head, and extremities) to each other. Flexion is resistance to the descent of the fetus down the birth canal, which causes the head to flex or bend so that the chin approaches the chest.
A--Complete flexion. B-- Moderate flexion. C--Poor flexion. D--Hyperextension Figure 10-2. Types of attitudes.
Figure 10-3. Measurement of station. d. Station. This refers to the depth that the presenting part has descended into the pelvis in relation to the ischial spines of the mother's pelvis. Measurement of the station is as follows:
e. Engagement. This refers to the entrance of the presenting part of the fetus into the true pelvis or the largest diameter of the presenting part into the true pelvis. In relation to the head, the fetus is said to be engaged when it reaches the midpelvis or at a zero (0) station. Once the fetus is engaged, it (fetus) does not go back up. Prior to engagement occurring, the fetus is said to be "floating" or ballottable.
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