Breech presentation
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This document provides an overview of breech presentation, including: - Defining breech presentation as when the fetus is positioned buttocks-first. - Describing the three types of breech presentation: flexed, extended, and footling. - Discussing the causes, diagnosis, differentiation from other presentations, and mechanisms of labor for breech births. - Detailing the increased risks for breech deliveries and recommendations for selecting vaginal versus cesarean delivery. - Outlining management approaches for the three stages of breech labor and delivery, including techniques for safely delivering the fetal head.
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Version
Version refers to changing the fetal lie or position in the uterus. There are three main types: external cephalic version, internal podalic version, and bipolar podalic version. External cephalic version involves manipulating the fetus externally to convert a breech presentation to head-first. Internal podalic version is performed under anesthesia when the cervix is fully dilated to grasp the fetus's feet and convert a transverse lie to breech. Bipolar podalic version uses both internal and external manipulation through a partially dilated cervix for special circumstances. Complications can include fetal distress, premature separation of the placenta, and maternal hemorrhage.
Shoulder dystocia
Shoulder dystocia is when the fetal shoulders become lodged at the maternal pelvis after delivery of the head, occurring in 0.2-2% of births. Risk factors include maternal diabetes, obesity, macrosomia, and prior shoulder dystocia. Management involves calling for help, applying suprapubic pressure and the McRoberts maneuver to widen the pelvis, and rotating the shoulders using maneuvers like Woods screw or Rubin. If unsuccessful, procedures include delivering the posterior arm or rarely symphysiotomy. Fetal risks are brachial plexus injury, fractures, and hypoxic brain injury. Maternal risks include perineal tears and postpartum hemorrhage. Prevention focuses
Rupture of the uterus
This document discusses uterine rupture, a serious obstetric complication where the wall of the pregnant uterus tears. It has a high risk of maternal and perinatal mortality. Uterine rupture can occur during labor, delivery, or rarely during pregnancy. It has an incidence of 0.05% for all pregnancies, rising to 0.8% for those with a previous cesarean section. Causes include a weak scar from prior uterine surgery, obstructed labor, or uterine overstimulation from medications. Symptoms include abdominal pain, vaginal bleeding, and non-reassuring fetal heart rate. Diagnosis is usually made during emergency surgery, with ultrasound sometimes identifying signs of rupture. Treatment requires intensive resuscitation
Breech presentation
This document discusses the diagnosis and management of breech presentations and breech births. It notes that breech presentations occur in 3-4% of term births. Risk factors include primigravidity, uterine anomalies, and fetal anomalies. For a vaginal breech birth, the cervix must be fully dilated and the fetal anus visible. The breech should be allowed to descend spontaneously and maneuvers like Lovset's may be needed to deliver the arms. The Mauriceau-Smellie-Veit maneuver is then used to slowly deliver the head. Complications may require emergency cesarean section.
Abnormalities of labour and delivery
This document discusses various abnormalities that can occur during labour and delivery, categorized as abnormalities of the power (uterine contractility), abnormalities involving the passenger (fetus), or abnormalities of the passage (pelvis). It provides details on specific issues like uterine dysfunction, fetopelvic disproportion, abnormal fetal presentations (breech, transverse lie), prolapsed umbilical cord, and shoulder dystocia. Management strategies are discussed for each abnormality, including oxytocin use, operative vaginal delivery, and Caesarean section when appropriate. The goal is to identify abnormalities early to guide management and prevent adverse maternal-fetal outcomes from difficult labor.
Brow presentation
A brow presentation occurs when the fetal head is midway between flexion and extension during labor. It is diagnosed by feeling the occiput and sinciput at the same level during pregnancy or seeing the frontal bones, supra-orbital ridges, and root of the nose but not the chin during vaginal exams. A persistent brow presentation has no mechanism for labor due to a longer engagement diameter, so cesarean section is required if in the second stage or living, while craniotomy is needed if deceased. Transient brow may convert allowing vaginal delivery, so careful observation is given in early labor before deciding on surgery.
Inversion of uterus by Sunil Kumar Daha
Please find the power point on Inversion of uterus. I tried to present it on understandable way and all the contents are reviewed by experts and from very reliable references. Thank you
Retained placenta
A retained placenta occurs when the placenta is not expelled from the uterus within 30 minutes of childbirth. Risk factors include previous retained placentas, uterine injuries or surgeries, preterm births, induced labor, and multiple pregnancies. Causes can include failure of the placenta to separate fully from the uterine wall or abnormal placenta attachments like placenta accreta. Treatment involves controlled cord traction, manual removal in the operating room if needed, or hysterectomy for deeply embedded placentas. Complications can be life-threatening bleeding, infections, or shock if not properly managed.
Recommended
Version
Version refers to changing the fetal lie or position in the uterus. There are three main types: external cephalic version, internal podalic version, and bipolar podalic version. External cephalic version involves manipulating the fetus externally to convert a breech presentation to head-first. Internal podalic version is performed under anesthesia when the cervix is fully dilated to grasp the fetus's feet and convert a transverse lie to breech. Bipolar podalic version uses both internal and external manipulation through a partially dilated cervix for special circumstances. Complications can include fetal distress, premature separation of the placenta, and maternal hemorrhage.
Shoulder dystocia
Shoulder dystocia is when the fetal shoulders become lodged at the maternal pelvis after delivery of the head, occurring in 0.2-2% of births. Risk factors include maternal diabetes, obesity, macrosomia, and prior shoulder dystocia. Management involves calling for help, applying suprapubic pressure and the McRoberts maneuver to widen the pelvis, and rotating the shoulders using maneuvers like Woods screw or Rubin. If unsuccessful, procedures include delivering the posterior arm or rarely symphysiotomy. Fetal risks are brachial plexus injury, fractures, and hypoxic brain injury. Maternal risks include perineal tears and postpartum hemorrhage. Prevention focuses
Rupture of the uterus
This document discusses uterine rupture, a serious obstetric complication where the wall of the pregnant uterus tears. It has a high risk of maternal and perinatal mortality. Uterine rupture can occur during labor, delivery, or rarely during pregnancy. It has an incidence of 0.05% for all pregnancies, rising to 0.8% for those with a previous cesarean section. Causes include a weak scar from prior uterine surgery, obstructed labor, or uterine overstimulation from medications. Symptoms include abdominal pain, vaginal bleeding, and non-reassuring fetal heart rate. Diagnosis is usually made during emergency surgery, with ultrasound sometimes identifying signs of rupture. Treatment requires intensive resuscitation
Breech presentation
This document discusses the diagnosis and management of breech presentations and breech births. It notes that breech presentations occur in 3-4% of term births. Risk factors include primigravidity, uterine anomalies, and fetal anomalies. For a vaginal breech birth, the cervix must be fully dilated and the fetal anus visible. The breech should be allowed to descend spontaneously and maneuvers like Lovset's may be needed to deliver the arms. The Mauriceau-Smellie-Veit maneuver is then used to slowly deliver the head. Complications may require emergency cesarean section.
Abnormalities of labour and delivery
This document discusses various abnormalities that can occur during labour and delivery, categorized as abnormalities of the power (uterine contractility), abnormalities involving the passenger (fetus), or abnormalities of the passage (pelvis). It provides details on specific issues like uterine dysfunction, fetopelvic disproportion, abnormal fetal presentations (breech, transverse lie), prolapsed umbilical cord, and shoulder dystocia. Management strategies are discussed for each abnormality, including oxytocin use, operative vaginal delivery, and Caesarean section when appropriate. The goal is to identify abnormalities early to guide management and prevent adverse maternal-fetal outcomes from difficult labor.
Brow presentation
A brow presentation occurs when the fetal head is midway between flexion and extension during labor. It is diagnosed by feeling the occiput and sinciput at the same level during pregnancy or seeing the frontal bones, supra-orbital ridges, and root of the nose but not the chin during vaginal exams. A persistent brow presentation has no mechanism for labor due to a longer engagement diameter, so cesarean section is required if in the second stage or living, while craniotomy is needed if deceased. Transient brow may convert allowing vaginal delivery, so careful observation is given in early labor before deciding on surgery.
Inversion of uterus by Sunil Kumar Daha
Please find the power point on Inversion of uterus. I tried to present it on understandable way and all the contents are reviewed by experts and from very reliable references. Thank you
Retained placenta
A retained placenta occurs when the placenta is not expelled from the uterus within 30 minutes of childbirth. Risk factors include previous retained placentas, uterine injuries or surgeries, preterm births, induced labor, and multiple pregnancies. Causes can include failure of the placenta to separate fully from the uterine wall or abnormal placenta attachments like placenta accreta. Treatment involves controlled cord traction, manual removal in the operating room if needed, or hysterectomy for deeply embedded placentas. Complications can be life-threatening bleeding, infections, or shock if not properly managed.
Placenta previa
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Mal presentation
The document discusses fetal malpresentation and malposition, which refer to abnormal positions of the fetus in the uterus. It describes different types of malpresentation including breech, transverse lie, brow, face, and sinciput presentations. It also discusses fetal malpositions including occipitoposterior and occipitotransverse positions. Diagnosis and management approaches are outlined for each type as well as nursing care considerations.
Rupture uterus
Uterine rupture is a life-threatening condition where the wall of the uterus tears, potentially exposing the fetus and placenta to the mother's abdominal cavity. It most commonly occurs in women with a previous cesarean section scar. Signs include acute abdominal pain, fetal distress, and hemorrhage. Diagnosis is often made using ultrasound or MRI to detect tears in the uterine wall. Immediate exploratory laparotomy and cesarean delivery is usually required for treatment. Conservative uterine repair may be attempted for some cases but hysterectomy is often necessary due to severe hemorrhage. Prevention focuses on careful management of trial of labor for women with previous scars.
Inversion Of Uterus
Uterine inversion occurs when the uterus turns inside out, most commonly during the third stage of labor due to excessive traction on the umbilical cord or fundal pressure. It can be incomplete, with just the fundus inverted, or complete, with the entire uterus emerging from the vagina or outside the body. Symptoms include hemorrhage, abdominal pain, and shock. Treatment involves immediate manual repositioning of the uterus if diagnosed early, or the O'Sullivan hydrostatic method using saline if delayed. Prevention relies on avoiding excessive fundal pressure or cord traction during delivery of the placenta.
Shoulder,face ,braw,,compound presention for undergraduate
Shoulder,face ,braw,,compound presention for undergraduateFaculty of Medicine,Zagazig University,EGYPT
Unergraduate course lectuers in Obstetrics&Gynecology,Faculty of medicine,Zagazig University Prepared by Dr Manal BeheryMalpresentations
This document discusses various types of malpresentations that can occur during labor, including face presentation, brow presentation, breech presentation, shoulder presentation, and unstable lie. It provides details on the diagnosis, management, and potential complications of each presentation. Face presentation is the most common type of malpresentation and can be diagnosed based on abdominal and vaginal exams. Brow presentation carries a high risk of obstructed labor requiring c-section. Shoulder presentation requires c-section delivery due to the inability to deliver the shoulders. Unstable lie increases the risk of cord prolapse so careful monitoring is needed.
Malpresentation (face, brow)
Face presentation occurs when the fetal chin presents at the pelvic inlet. The mentum engages in either a right or left oblique diameter. While mentoanterior positions often rotate anteriorly and deliver vaginally, mentoposterior positions have a 25% chance of persisting or rotating posteriorly, requiring cesarean section. Brow presentation involves the fetal forehead presenting and is not suitable for vaginal delivery due to the large engaging diameter. It usually converts to vertex or face but if persistent requires cesarean section.
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Vbac
This document provides recommendations and guidelines for vaginal birth after cesarean (VBAC). It outlines that VBAC can be allowed for women with one previous low transverse cesarean incision as long as the pelvis is adequately sized and there are no other uterine scars or previous uterine ruptures. Facilities for emergency cesarean delivery and 24/7 obstetrician availability are required. Women should be properly counseled on risks and monitored closely during a trial of labor, which should only occur in a well-equipped hospital. Risks include an unsuccessful vaginal delivery, scar dehiscence or rupture, and associated maternal and perinatal morbidity.
Face presentation
Face presentation occurs when a baby's head is fully extended so the face is the leading part. It has an incidence of about 1 in 300 births. Face presentations are either primary, occurring during pregnancy due to fetal anomalies, or secondary, occurring during labor due to factors like a contracted pelvis. The most common positions are right and left mento-posterior and mento-anterior. Diagnosis is made through palpation and ultrasound. Labor progresses through engagement, flexion or rotation of the chin, and restitution. Failure of rotation to mento-anterior usually requires interventions like c-section.
Inversion of the uterus
Uterine inversion is a rare complication where the uterus turns inside out, and can be partial or complete. It occurs in around 1 in 20,000 deliveries and is usually acute and complete. There are three degrees - first involves dimpling of the fundus, second passes through the cervix into the vagina, and third is complete outside the vulva. Treatment involves urgent manual replacement or hydrostatic replacement under anesthesia to prevent shock, hemorrhage, infection and other complications. Proper management of the third stage of labor can prevent induced inversions.
Normal and abnormal labour
The document discusses normal labour and delivery. It describes the stages of labour including the first, second, and third stages. It explains the interaction between the powers (uterine contractions), passengers (fetus), and passages (pelvis and birth canal). It discusses assessing cervical dilation, fetal position and station, and monitoring the fetus. It also covers managing each stage of labor, identifying abnormal labour, and addressing complications.
Breech presentation
Breech presentation occurs when the fetus is positioned longitudinally with the buttocks or feet closest to the cervix. This is the most common malpresentation and is more likely to occur earlier in gestation. Predisposing factors include maternal fibroids or uterine anomalies, and fetal abnormalities like anencephaly. Management options include external cephalic version (ECV) to rotate the fetus, vaginal delivery if the breech is extended or flexed, or elective cesarean section. ECV has a higher success rate in multiparous women and is performed after 37 weeks to reduce cesarean delivery. Vaginal breech delivery requires experienced assistance and careful fetal monitoring due to risks of cord pro
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Shoulder dystocia
Shoulder dystocia occurs when the fetal shoulder becomes impacted at the mother's pelvis during childbirth, making delivery difficult. Risk factors include previous shoulder dystocia, macrosomia, diabetes, obesity, and induction of labor. Signs include failure of the shoulder to descend after the head is delivered. Management involves maneuvers like McRoberts and Wood's to widen the pelvis as well as rotating or delivering the posterior arm. Complications for the baby include brachial plexus injury, fractures, or asphyxia. Maternal risks are postpartum hemorrhage, tears, rupture of uterus or bladder.
Abnormal+labour
This document discusses abnormal labor and its management. It defines normal labor and describes abnormal labor as a difficult labor pattern that deviates from typical progression. Abnormal labor can be caused by issues with the cervix, uterus, maternal pelvis, or fetus. It further outlines the stages of labor and describes factors that can contribute to prolonged latent phase, dysfunctional labor, and dystocia. The management of abnormal labor may include amniotomy, oxytocin administration, operative vaginal delivery, or cesarean section depending on the specific issues present and labor progression. Close monitoring of labor and timely interventions are important to properly manage abnormal labor.
Obstructed labour
Obstructed labor occurs when the fetal presenting part fails to descend through the birth canal despite adequate uterine contractions, due to mechanical obstruction. Risk factors include malnutrition, previous C-section or prolonged labor, and young maternal age. Causes can be faults in the passage, such as a contracted pelvis, or faults in the passenger, like abnormal fetal positioning. Complications for both mother and baby include exhaustion, fistulas, infection, and perinatal death. Prevention focuses on antenatal screening and timely intervention during labor showing lack of progress. Treatment aims to relieve the obstruction through procedures like C-section, instrumental delivery, or rarely symphysiotomy.
3 malpresentations.warda (3)- FACE PRESENTATION
Face presentations occur when the fetal chin is the presenting part instead of the vertex. They are classified into four positions based on the position of the chin. Mentoanterior positions are more common and favorable than mentoposterior positions. Labor is usually prolonged in face presentations due to delayed engagement and lack of molding of the facial bones. Management depends on the position, with mentoanterior positions usually allowing vaginal delivery while mentoposterior positions often requiring assistance. Brow presentations are the rarest type and usually do not have a defined mechanism of labor.
Caesarean section - indications and types
Caesarean section is the removal of a child through an incision in the abdominal wall of an intact uterus. The incidence of caesarean sections has increased worldwide in the last 25 years, mainly due to repeat caesareans, dystocia, and fetal distress. Indications for caesarean section include maternal factors like previous c-sections, fetal distress, and fetal-maternal factors. The most common type is a lower segment caesarean section (LSCS) which involves a transverse incision in the lower uterine segment. While caesarean section can be life-saving, it carries more risks than a planned vaginal delivery.
Retained placenta
Retained placenta can be defined as lack of placental expulsion within 30 minutes of delivery of an infant. it is more common in preterm. Retained Placenta can lead to massive PPH and increase maternal morbidity and mortality.
Breech presentation
Breech Presentation & its Mx document discusses breech birth, including:
1) Breech presentation occurs in 3-5% of births and can be frank, incomplete, or complete.
2) Diagnosis is made through abdominal palpation, vaginal exam, and ultrasound to determine type and rule out anomalies.
3) Perinatal mortality is higher for breech births due to risks of malformations, trauma, and asphyxia.
External cephalic version after 36 weeks and assisted vaginal delivery can be attempted if criteria are met, otherwise cesarean delivery is recommended.
Breech presentation
types of breech
how you can manage a woman with breech baby?
what is External cephalic version and who can do it ?
what is the risks of vaginal breech birth ?
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Mal presentation
The document discusses fetal malpresentation and malposition, which refer to abnormal positions of the fetus in the uterus. It describes different types of malpresentation including breech, transverse lie, brow, face, and sinciput presentations. It also discusses fetal malpositions including occipitoposterior and occipitotransverse positions. Diagnosis and management approaches are outlined for each type as well as nursing care considerations.
Rupture uterus
Uterine rupture is a life-threatening condition where the wall of the uterus tears, potentially exposing the fetus and placenta to the mother's abdominal cavity. It most commonly occurs in women with a previous cesarean section scar. Signs include acute abdominal pain, fetal distress, and hemorrhage. Diagnosis is often made using ultrasound or MRI to detect tears in the uterine wall. Immediate exploratory laparotomy and cesarean delivery is usually required for treatment. Conservative uterine repair may be attempted for some cases but hysterectomy is often necessary due to severe hemorrhage. Prevention focuses on careful management of trial of labor for women with previous scars.
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Uterine inversion occurs when the uterus turns inside out, most commonly during the third stage of labor due to excessive traction on the umbilical cord or fundal pressure. It can be incomplete, with just the fundus inverted, or complete, with the entire uterus emerging from the vagina or outside the body. Symptoms include hemorrhage, abdominal pain, and shock. Treatment involves immediate manual repositioning of the uterus if diagnosed early, or the O'Sullivan hydrostatic method using saline if delayed. Prevention relies on avoiding excessive fundal pressure or cord traction during delivery of the placenta.
Shoulder,face ,braw,,compound presention for undergraduate
Shoulder,face ,braw,,compound presention for undergraduateFaculty of Medicine,Zagazig University,EGYPT
Unergraduate course lectuers in Obstetrics&Gynecology,Faculty of medicine,Zagazig University Prepared by Dr Manal BeheryMalpresentations
This document discusses various types of malpresentations that can occur during labor, including face presentation, brow presentation, breech presentation, shoulder presentation, and unstable lie. It provides details on the diagnosis, management, and potential complications of each presentation. Face presentation is the most common type of malpresentation and can be diagnosed based on abdominal and vaginal exams. Brow presentation carries a high risk of obstructed labor requiring c-section. Shoulder presentation requires c-section delivery due to the inability to deliver the shoulders. Unstable lie increases the risk of cord prolapse so careful monitoring is needed.
Malpresentation (face, brow)
Face presentation occurs when the fetal chin presents at the pelvic inlet. The mentum engages in either a right or left oblique diameter. While mentoanterior positions often rotate anteriorly and deliver vaginally, mentoposterior positions have a 25% chance of persisting or rotating posteriorly, requiring cesarean section. Brow presentation involves the fetal forehead presenting and is not suitable for vaginal delivery due to the large engaging diameter. It usually converts to vertex or face but if persistent requires cesarean section.
Occipito posterior position
This topic contains definition, incidence, types, causes, diagnosis, mechanism, management of occipito posterior position and deep transverse arrest and manual rotation of occipito posterior position
Vbac
This document provides recommendations and guidelines for vaginal birth after cesarean (VBAC). It outlines that VBAC can be allowed for women with one previous low transverse cesarean incision as long as the pelvis is adequately sized and there are no other uterine scars or previous uterine ruptures. Facilities for emergency cesarean delivery and 24/7 obstetrician availability are required. Women should be properly counseled on risks and monitored closely during a trial of labor, which should only occur in a well-equipped hospital. Risks include an unsuccessful vaginal delivery, scar dehiscence or rupture, and associated maternal and perinatal morbidity.
Face presentation
Face presentation occurs when a baby's head is fully extended so the face is the leading part. It has an incidence of about 1 in 300 births. Face presentations are either primary, occurring during pregnancy due to fetal anomalies, or secondary, occurring during labor due to factors like a contracted pelvis. The most common positions are right and left mento-posterior and mento-anterior. Diagnosis is made through palpation and ultrasound. Labor progresses through engagement, flexion or rotation of the chin, and restitution. Failure of rotation to mento-anterior usually requires interventions like c-section.
Inversion of the uterus
Uterine inversion is a rare complication where the uterus turns inside out, and can be partial or complete. It occurs in around 1 in 20,000 deliveries and is usually acute and complete. There are three degrees - first involves dimpling of the fundus, second passes through the cervix into the vagina, and third is complete outside the vulva. Treatment involves urgent manual replacement or hydrostatic replacement under anesthesia to prevent shock, hemorrhage, infection and other complications. Proper management of the third stage of labor can prevent induced inversions.
Normal and abnormal labour
The document discusses normal labour and delivery. It describes the stages of labour including the first, second, and third stages. It explains the interaction between the powers (uterine contractions), passengers (fetus), and passages (pelvis and birth canal). It discusses assessing cervical dilation, fetal position and station, and monitoring the fetus. It also covers managing each stage of labor, identifying abnormal labour, and addressing complications.
Breech presentation
Breech presentation occurs when the fetus is positioned longitudinally with the buttocks or feet closest to the cervix. This is the most common malpresentation and is more likely to occur earlier in gestation. Predisposing factors include maternal fibroids or uterine anomalies, and fetal abnormalities like anencephaly. Management options include external cephalic version (ECV) to rotate the fetus, vaginal delivery if the breech is extended or flexed, or elective cesarean section. ECV has a higher success rate in multiparous women and is performed after 37 weeks to reduce cesarean delivery. Vaginal breech delivery requires experienced assistance and careful fetal monitoring due to risks of cord pro
Ventouse or vaccum delivery
This topic contains definition, instruments, indications, contraindications, prerequisites, advantages, procedure, complications and hazards of ventouse or vaccum delivery.
Shoulder dystocia
Shoulder dystocia occurs when the fetal shoulder becomes impacted at the mother's pelvis during childbirth, making delivery difficult. Risk factors include previous shoulder dystocia, macrosomia, diabetes, obesity, and induction of labor. Signs include failure of the shoulder to descend after the head is delivered. Management involves maneuvers like McRoberts and Wood's to widen the pelvis as well as rotating or delivering the posterior arm. Complications for the baby include brachial plexus injury, fractures, or asphyxia. Maternal risks are postpartum hemorrhage, tears, rupture of uterus or bladder.
Abnormal+labour
This document discusses abnormal labor and its management. It defines normal labor and describes abnormal labor as a difficult labor pattern that deviates from typical progression. Abnormal labor can be caused by issues with the cervix, uterus, maternal pelvis, or fetus. It further outlines the stages of labor and describes factors that can contribute to prolonged latent phase, dysfunctional labor, and dystocia. The management of abnormal labor may include amniotomy, oxytocin administration, operative vaginal delivery, or cesarean section depending on the specific issues present and labor progression. Close monitoring of labor and timely interventions are important to properly manage abnormal labor.
Obstructed labour
Obstructed labor occurs when the fetal presenting part fails to descend through the birth canal despite adequate uterine contractions, due to mechanical obstruction. Risk factors include malnutrition, previous C-section or prolonged labor, and young maternal age. Causes can be faults in the passage, such as a contracted pelvis, or faults in the passenger, like abnormal fetal positioning. Complications for both mother and baby include exhaustion, fistulas, infection, and perinatal death. Prevention focuses on antenatal screening and timely intervention during labor showing lack of progress. Treatment aims to relieve the obstruction through procedures like C-section, instrumental delivery, or rarely symphysiotomy.
3 malpresentations.warda (3)- FACE PRESENTATION
Face presentations occur when the fetal chin is the presenting part instead of the vertex. They are classified into four positions based on the position of the chin. Mentoanterior positions are more common and favorable than mentoposterior positions. Labor is usually prolonged in face presentations due to delayed engagement and lack of molding of the facial bones. Management depends on the position, with mentoanterior positions usually allowing vaginal delivery while mentoposterior positions often requiring assistance. Brow presentations are the rarest type and usually do not have a defined mechanism of labor.
Caesarean section - indications and types
Caesarean section is the removal of a child through an incision in the abdominal wall of an intact uterus. The incidence of caesarean sections has increased worldwide in the last 25 years, mainly due to repeat caesareans, dystocia, and fetal distress. Indications for caesarean section include maternal factors like previous c-sections, fetal distress, and fetal-maternal factors. The most common type is a lower segment caesarean section (LSCS) which involves a transverse incision in the lower uterine segment. While caesarean section can be life-saving, it carries more risks than a planned vaginal delivery.
Retained placenta
Retained placenta can be defined as lack of placental expulsion within 30 minutes of delivery of an infant. it is more common in preterm. Retained Placenta can lead to massive PPH and increase maternal morbidity and mortality.
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Shoulder,face ,braw,,compound presention for undergraduate
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Breech Presentation & its Mx document discusses breech birth, including:
1) Breech presentation occurs in 3-5% of births and can be frank, incomplete, or complete.
2) Diagnosis is made through abdominal palpation, vaginal exam, and ultrasound to determine type and rule out anomalies.
3) Perinatal mortality is higher for breech births due to risks of malformations, trauma, and asphyxia.
External cephalic version after 36 weeks and assisted vaginal delivery can be attempted if criteria are met, otherwise cesarean delivery is recommended.
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This document describes the mechanism of labor for breech births. It explains that delivery occurs in three stages: 1) delivery of the breech (buttocks and lower limbs), which involves engagement, descent, flexion, internal rotation and birth of the buttocks; 2) delivery of the shoulders and arms, through engagement, descent, internal rotation, and birth of the shoulders; and 3) delivery of the head, through engagement, descent, flexion, internal rotation and birth of the head. Each stage involves the baby engaging and descending through the pelvis, rotating internally, and flexing to be born.
Breech presentation
This document discusses breech presentation, which occurs when the fetus is in a longitudinal lie with the buttocks or feet presenting at the pelvic brim instead of the head. The incidence is about 3-4% and spontaneous correction usually occurs by 34 weeks. Breech presentations are classified as complete or incomplete. Etiologies include prematurity, factors preventing version, fetal abnormalities, and multiparity. Diagnosis involves clinical examination and sonography to determine type and position of breech.
Breech presentation
This document discusses breech presentation, including its definition, types, diagnosis, and management. Some key points:
- Breech presentation is when the buttocks or lower limbs present first. It occurs in 3.5% of term deliveries and up to 25% of preterm deliveries.
- Types include complete breech, frank breech, and footling breech. Diagnosis is made through inspection, palpation, auscultation, and ultrasound.
- Management options are external cephalic version, vaginal delivery for some cases, or caesarean section which is recommended for complicated breeches or large babies. Vaginal delivery carries risks of complications for
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This document discusses breech presentation during childbirth. It defines breech presentation and notes its incidence decreases with gestational age. Complications for mother and baby from breech delivery are described. The document classifies breech presentations and reviews etiology, diagnosis, labor mechanism, and management approaches including external cephalic version, vaginal delivery, and cesarean section. Specific techniques for assisting various stages of vaginal breech delivery are outlined. Factors influencing management decisions are also summarized.
Breech presentation..pptx
This document discusses breech presentation, including its definition, incidence, varieties, etiology, clinical diagnosis, investigations, mechanism of labor, complications of vaginal breech delivery, antenatal management, and management of vaginal and complicated breech deliveries. Some key points include:
- Breech presentation occurs in 3-4% of pregnancies at term, with the fetus in a longitudinal lie and the buttocks at the pelvic brim.
- Varieties include complete, incomplete (frank or footling), and knee breech.
- Etiology may include prematurity, factors preventing version, fetal abnormalities, and uterine anomalies.
- External cephalic version can be attempted after
BREECH PRESENTATION
Breech presentation occurs when the fetus lies longitudinally with the pelvic or podalic pole presenting at the birth canal instead of the head. It has an incidence of 3-15% depending on gestational age. There are various types of breech including complete, frank, and footling. Breech delivery can be managed through external cephalic version, vaginal delivery, or cesarean section depending on the fetal position and other risk factors. Vaginal breech delivery requires skilled assistance and maneuvers to safely deliver the fetus in stages starting with the buttocks and hips, shoulders, and finally the head. Complications for mother and baby can include injuries if not properly managed.
1.normal labor & delivery.pptx
This document provides information about normal labor and delivery. It begins with defining terms like labor, normal labor, abnormal labor, and preterm labor. It then discusses the components of labor, including the powers (uterine contractions), passenger (fetus), passageway (maternal pelvis), and psyche (maternal psychological response). The stages of labor are introduced as the first stage (cervical dilation) and second stage (expulsion). The document provides detailed information about each component and stage of labor.
Uterovaginal prolapse by Dr zarkaish
A 58-year-old woman presents with pelvic heaviness and sensation of something protruding from her vagina that worsens with exertion. She sometimes feels and sees a bulge from her vagina and needs to push it back in to empty her bladder fully. The most likely diagnosis is pelvic organ prolapse. The doctor will examine her with a speculum while straining to determine the degree of prolapse. Conservative management with pelvic floor exercises and potentially a pessary will be recommended initially, with surgery as an option if symptoms persist or worsen.
breech-presentation.ppt
The course is designed to assists student to acquire comprehensive knowledge of the normal functions of the organ systems of the human body to facilitate understanding of physiological basis of health, identify alteration in functions and provide the student with the necessary physiological knowledge to practice nursing.
On completion of the course, the students will be able to
1. Develop understanding of the normal functioning of various organ systems of the body.
2. Identify the relative contribution of each organ system towards maintenance of homeostasis.
3. Describe the effect of alterations in functions.
4. Apply knowledge of physiological basis to analyze clinical situations and therapeutic applications.
1. describe the physiology of cell, tissues, membranes and glands.
2. describe the physiology and mechanism of respiration
3. identify the muscles of respiration and examine their contribution to the mechanism
4. describe the functions of digestive system
5. explain the functions of the heart, and physiology of circulation
6. describe the composition and functions of blood
7. identify the major endocrine glands and describe their functions
8. describe the structure of various sensory organs
9. describe the functions of bones, joints, various types of muscles, its special properties and nerves supplying them.
10. describe the physiology of renal system
11. describe the structure of reproductive system
12. describe the functions of brain, physiology of nerve stimulus, reflexes, cranial and spinal nerves.
ABNORMAL LABOUR PPT.pptx
This document discusses abnormal labor and dystocia. It defines abnormal labor as difficult labor characterized by abnormal slow progression due to problems with the passenger (fetus size/position), pelvis (size/shape), or power (uterine contractility). Specific causes of abnormal labor discussed include cephalopelvic disproportion (CPD), obstructed labor, shoulder dystocia, breech presentation, and fetal malpositions. The signs, risks, and management of these complications are described. Obstructed labor is defined as cessation of labor progression despite adequate contractions due to mechanical obstruction, and can lead to maternal death if not properly managed.
operative obstetrics emergency.pptx
This document provides an overview of obstetrical emergencies including uterine rupture and shoulder dystocia. For uterine rupture, it defines the condition, describes the causes, clinical features, and management approach. Management involves supportive care like IV fluids and antibiotics followed by definitive surgery like repair or hysterectomy. For future pregnancies, cesarean delivery is recommended. For shoulder dystocia, it defines the condition, discusses prediction and clinical presentation. Management involves initial maneuvers applied sequentially like McRoberts, Woods screw, and extraction of the posterior arm. More invasive options like clavicular fracture or Zavanelli maneuver may be considered if initial attempts fail. Complications for both mother and baby are described.
Malpresentations & Malpositions copy.pptx
This document outlines various fetal malpresentations and malpositions that can occur during labor and delivery. It discusses normal presentation and position, as well as abnormal presentations including occiput posterior, face, brow, breech, transverse lie, shoulder, and compound. For each presentation, the document describes causes, diagnosis techniques including Leopold's maneuvers and ultrasound, and approaches to delivery management. Breech presentation is discussed in particularly depth, outlining types of breech, risk factors, techniques for external cephalic version and vaginal breech delivery.
Abnormal labor
Abnormal labor or dystocia can be caused by problems with uterine contractions (uterine dysfunction), issues with the baby's size or position (fetopelvic disproportion), or a narrow pelvis (contracted pelvis). Common types include protracted or arrested dilation, shoulder dystocia, and breech presentation. Obstructed labor occurs when progress stalls despite adequate contractions, typically due to a mechanical obstruction, and can lead to serious maternal complications if not addressed. Management may involve resuscitation, expedited delivery depending on fetal/maternal status, and transfer to a higher level facility for those in advanced labor.
Normal labour newest
The document discusses normal labor and defines its criteria. It describes the stages of labor and nursing care provided in each stage. Key points include defining normal labor as spontaneous delivery of a mature fetus through the birth canal within 24 hours without complications, describing the three stages of labor as dilation, birth of the baby, and delivery of the placenta. Nursing care focuses on comfort measures, monitoring labor progress, and providing pain management.
Abnormal labor neonatal pg (1).pptx
1) Prolonged and obstructed labor can lead to serious maternal and fetal complications if not properly managed. Prolonged labor is defined as lasting over 24 hours, while obstructed labor occurs when there is no advancement of the presenting fetal part despite adequate contractions.
2) Causes of prolonged labor include issues with the passenger (fetus), passages (pelvis), powers (uterine contractions), or psychological factors in the mother. Obstructed labor is usually due to problems like a contracted pelvis, large baby, or malpresentation that prevent fetal descent.
3) Management of prolonged labor may include accelerating labor with oxytocics, instrumental delivery, or c-section depending on findings.
USMLE REPRODUCTIVE 05 Prolapse of Uterus Vagina Vagina Vagina .pdf
he uterus and vagina are supported by various structures and connective tissues, and the integrity of these supporting factors is crucial for maintaining pelvic organ function and preventing conditions such as pelvic organ prolapse.
Understanding the anatomy and surgical importance of the supporting factors of the uterus and vagina is essential for gynecologists, urogynecologists, and pelvic reconstructive surgeons involved in the diagnosis and management of pelvic organ prolapse and related conditions.
Labor-and-delivery.pdf
Normal labor and delivery typically begins within 2 weeks of the estimated due date. Labor usually lasts 12-18 hours for a first pregnancy and 6-8 hours for subsequent pregnancies. Labor has three stages: first stage involves cervical dilation from 0-10cm; second stage is baby's delivery; third stage is placenta delivery. Key factors that influence labor include the fetus, mother's pelvis, and uterine contractions. Normal labor results in spontaneous vaginal delivery of a healthy baby in under 18 hours without complications.
01 LABOUR.ppt
This document discusses the process of labor and outlines the female pelvis and fetal skull anatomy. It describes the stages of normal labor and the mechanism of labor. Abnormal labor patterns including protraction disorders and arrest disorders are defined. Risk factors for abnormal labor include older age, diabetes, and prior complications. Dystocia can cause issues for both the mother and neonate. Causes of dystocia are classified as abnormal power, abnormal passage, or abnormal passenger. Management may include supportive care, augmentation, and operative delivery depending on the type of dystocia. The role of the partograph in monitoring labor is also summarized.
BREECH PRESENTATION.pptx
Breech presentation occurs when a baby is positioned bottom or feet first in the womb rather than head first. It has an incidence of around 3-4% at term. Breech presentation is managed through attempts at external cephalic version to turn the baby or vaginal breech delivery. Vaginal breech delivery requires careful management of the delivery of the aftercoming head to avoid injury. Complications of breech delivery include birth injuries, asphyxia, and increased intervention.
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BREECH PRESENTATION obstetrics and gynacology mbbs final year
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USMLE REPRODUCTIVE 05 Prolapse of Uterus Vagina Vagina Vagina .pdf
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Breech presentation
- 1. Breech presentation Dr Hayder Al Shamma’a
- 2. objectives • The student should be able to define breech presentation • Able to differentiate the types • Should be able to describe the mechanism of labour • Should be able to list the causes • Able to list and describe the complications • Should be able to diagnose the condition and differentiate it from face presentation • Should be able to manage 1st , and 3rd stages of labour • should be able to select patients for breech vaginal delivery • Should have an idea about ECV and know the complications and contraindications
- 3. •Occurs when the leading part of the fetus is the buttock (breech) •2-3% of term pregnancy •The denominator is the sacrum
- 4. Causes of breech presentation 1. Prematurity ( at 30 wks. 25% breech ) 2. Uterine abnormalities 3. Fetal factors prevent spontaneous version 4. Placenta previa 5. fibroids 6. Hydrocephaly 7. unknown
- 5. Types of breech I. Flexed breech (complete breech) , hips flexed , knees flexed. common in multiparous women. The presenting part is irregular and not fit well onthe cx II. Extended breech (frank breech) , Hips flexed, knees extended . common in primigravida. Fits well on the cx III. Footling breech , partial extensionof one or both hips ( the feet below the buttock ).
- 8. Diagnosis of breech •On abdominal examination:- •Long. Lie •Head felt at the fundus as hard rounded mass smooth and ballotable •Lower segment feels as firm irregular non ballotable mass •Fetal heart heard above the umbilicus .
- 9. •On vaginal examination:- •Signs of mal-presentation •Feel the soft buttocks •Soft natal cleft •Irregular hard sacrum •Hard ischeal tuberosities •The anus with tuberosities form a strait line •The feet can be felt
- 10. Differentiation from face •Soft cheecks •Hard chin •Hard maxillae •Chin and maxillae form triangle •Mouth in the center of the triangle •(while anus at the base of the triangle between the tuberosities )
- 11. Differentiation between hand and foot •The foot has a prominent heal , no heal in the hand •The thumb can be abducted to 90 ,while the big toe can not
- 12. Mechanism of labor •The largest diameter of the breech is the bitrochanteric diameter of 10 cm •Engagement of the bitrocanteric diameter in the transverse or oblique diameter of the pelvis (Left sacro-anterior or direct sacro-anterior) •Descent in pelvic cavity followed by rotationone buttock becomes anterior •Further descend by lateralbend of the trunk •Delivery of anterior buttock followedby the posterior
- 13. Mech. Of breech ..continue •Then engagement of the shoulders (bisacromial diametr in transverse or oblique diameter followed by descend of the shoulders and rotation •One shoulder become anterior and delivered first
- 14. Mech. Of breech ..continue •Engagement of the head now start to effect in the oblique diameter of the pelvis (LOA)with descend of the head it rotates to OA •Rarely rotates to OP difficult labor !!! •The head delivers by flexion
- 16. Prognosis of breech delivery • Perinatal mortalities is X4 1. Hypoxia a) delayed delivery of the head b) cord compression c) reduced placental flow ( uterine retraction ) d)respiratory efforts aspiration of clots or meconium 2. Intracranial hemorrhage (rapid delivery of the head ,compression decompression of the head ) as no time for molding 3. Cervical spine injuries from excessive traction on the shoulder 4. Soft tissue injuries ( rupture spleen, liver and bowel) 5. Fractures of long bones
- 17. Prognosis of breech, continue…. •Maternal risks 1. Increased operative deliveries 2. Increased Genital tract injuries 3. Increased Cesarean section 4. Increased Risks of anesthesia But the major disadvantage of vaginal breech delivery is burdened by the fetus
- 18. Management of breech •Wait to 36 wks •Consider external cephalic version ECV if 1. No indication for C/S 2. Technically possible ( normal liquor, fetal size, relaxed uterus ,etc…..) 3. No contraindication.( previous C/S, APH, PE, twins, bad obstetric history, abnormal baby, infertility , etc….)
- 20. Risks of ECV 1. Premature labour 2. Premature preterm rupture of membranes (PPROM) 3. Feto-maternal transfusion 4. Formation of knotes in the cord 5. Abruptioplacentae.
- 21. Management of persistant breech • Selection of cases for vaginal delivery Assessment for medical or obstetrical risks 1. PE 2. diabetes 3. bad history 4. Rh isoimmunization 5. footling breech 6. previous C/S 7. suspected CPD 8. fetal wt 3.7 kg 9. gestational age 40 wks. 10. others like wish of the parents All need elective C/S
- 22. Management of vaginal breech delivery •First stage managed as high risk labor •2nd stage should be conducted by the most senior resident available •Patient should be in lithotomy position •Iv fluid ,epidural anesthesia available
- 23. Management of vaginal breech delivery continue The second stage managed as follows 1. Spontaneous delivery till the umbilicus 2. Rapid delivery of the trunk and shoulders 3. Controlled delivery of the head in 4-6 minuets
- 24. Delivery of the head •3 methods 1. Burns Marshal method 2. Jaw flexion shoulder traction 3. Forceps for the after-coming head
- 25. Burns Marshal /Prague Seizure method
- 26. Jaw flexion/ shoulder traction
- 27. Forceps for the after-coming head