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Lesson 10: Fetal Positions and Adaptations |
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f. Position. This is the relationship between a predetermined point of reference or direction on the presenting part of the fetus to the pelvis of the mother.
NOTE: Remember that when you are describing the quadrants, view them as the mother would. O). This refers to the Y sutures on the top of the head. 2 Brow or fronto ( F). This refers to the diamond sutures or anterior fontanel on the head.3 Face or chin presentation ( M). This refers to the mentum or chin.(b) Breech or butt presentation. S). This is the point of reference. 2 Breech birth is associated with a higher perinatal mortality. (c) Shoulder presentation. Sc) or its upper tip, the acromion (A) would be used for the point of reference. (3) Coding of positions. R for right, L for left). 2 The second letter tells what reference point on the fetus is being used (Occiput- O, Fronto-F, Mentum-M, Breech-S, Shoulder-Sc or A).3 The last letter tells which half of the pelvis the reference point is in (anterior- A, posterior-P, transverse or in the middle-T).O.S.) or occiput at posterior (O.P.). 2 Occiput at pubis ( O.P.) or occiput at anterior (O.A.).(4) Types of breech presentations (see figure10-4). (a) Complete or full breech. This involves flexion of the fetus legs. It looks like the fetus is sitting in a tailor fashion. The buttocks and feet appear at the vaginal opening almost simultaneously.
A--Complete. B--Frank. C--Incomplete. Figure 10-4. Breech positions. LOA and ROA positions are the most common and permit relatively easy delivery. (b) LOP and ROP positions usually indicate labor may be longer and harder, and the mother will experience severe backache.
Figure 10-5. Examples of fetal vertex presentations in relation to quadrant of maternal pelvis.
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