BAG TECHNIQUE Bag technique-a tool making use of public health bag through wh...
face_presentation.pptx
1. FACE PRESENTATION
• DIGNOSTIC LANDMARKS-EYES,NOSE MOUTH
AND CHIN
• POSITION-MENTO
ANTERIOR/POSTERIOR,MENTO TRANSVERSE
• MANAGEMENT GUIDELINES-FETUS IS DEAD
OR ALIVES WITH ANOMALIES INCOMPATABLE
WITH LIFE,ALLOW VAGINAL DELIVERY
• MENTO ANTERIOR ,R/O FPD
2. FACE PRESENTATION AND BROW
IF LABOUR IS PROGRESSING WELL
MENTO POSTERIOR- C/S
BROW -NORMALLY INCOMPATABLE WITH
VAGINAL DELIVERY
DIAGNOSTIC LANDMARKS-ROOT OF THE
NOSE,SUPRAORBITAL RIDGES,ANTERIOR
FONTANEL
MANAGEMENT - CESARIAN SECTION
3. SHOULDER PRESENTATION
• DIAGNOSTIC LANDMARKS
• UTERUS IS ENLARGED TRANSVERSLY AND
SHORTENED VERTICALLY
• EMPTINESS AT THE LOWER POLE
• ON PV PALPABLE CLAVICLE ,RIBS ARM
PROLAPSE
4. MANAGEMENT
• WITH FETUS ALIVE –C/SECTION
• WITH FETUS DEAD-DESTRUCTIVE
OPERATION,OR C/S
• COMPOUND PRESENTAION
• PROLAPSE OF ONE OR MORE LIMBS IN
CEPHALIC PRESENTATION
• PROLAPSE OF HAND OR ARM IN BREECH
PRESEENTATION
5. COMPOUND PRESENTATION
• PUSH THE HAND ABOVE THE FETAL HEAD
• ARM MAY BE DIFFICULT TO REPLACE AND
CESARIAN SECTION MAY BE NECESSARY
• MALPOSITION
• INCORRECT POSITIONING OF THE VERTEX
• OCCIPITO POSTERIOR POSITION
• PERSISTENT O.P.P
6. 0CCIPITO POSTERIOR POSITION
• DIAGNOSIS
• PALPATION
• AUSCULTATION
• VAGINAL EXAMINATION
• LONG ROTATION-135° --OCCIPITO ANTERIOR-
SVD EXPECTED
• SHORT ROTATION- 45°--FACE TO PUBIS—AVD
OR C/SECTION
10. BREECH PRESENTATION
WHEN THE BUTTOCKS AND/OR THE FEET ARE
THE PRESENTING PARTS
THE COMMONEST MALPRESENTATION
HAS HIGHER PERINATAL MORTALITY AND
MORBIDTY
CAUSES OF BREECH PRESENTATION-
PREMATURITY,MULTIPLE PREGNANCY,FETAL
MALFORMATION,HYDRAMNIOUS
11. CLASSIFICATION AND RISKS
• COMPLETE
• FRANK
• FOOTLING
• INTRAPARTUM RISK TO THE FETUS-CORD
ACCIDENTS,FRACTURE AND DISLOCATION OF
LIMBS,DAMAGE TO INTRA-ABDOMINAL
ORGANS,INTRACRANIAL
HAEMORRHAGE,DAMAGE TO THE CERVICAL
SPINE AND BRACHIAL PLEXUS
13. VAGINAL DELIVERY
• KEEP MEMBRANES INTACT AS LONG AS
POSSIBLE
• BREECH IS SMALLER THAN THE AFTER
COMING HEAD
• BEFORE BEARING DOWN THE CERVIX MUST
BE FULLY DILATED
• LET THE BREECH DESCEND TO THE PERINEUM
14. ANATOMICAL LANDMARKS
• ANTERIOR BUTTOCKS BEGIN TO DISTEND
PERINEUM- ACTION?
THEN POSTERIOR BUTTOCKS- ACTION?
• HIPS –LEGS FLEXED- ACTION?
• HIPS- LEGS EXTENDED-ACTION?
• UMBILICUS- ACTION?
• SCAPULA- ACTION?
• NAPE OF THE NECK-ACTION?
16. Complications of breech delivery
• EXTENDED ARMS
• NUCHAL ARM
• OCCIPUT POSTERIOR OF THE AFTERCOMING
HEAD
• HEAD ENTRAPMENT BY INCOMPLETELY
DILATED CERVIX