This document discusses fetal positioning and presentations during labor. It begins by defining presentations other than vertex, such as breech, face, brow, and transverse. It then lists potential risk factors for abnormal presentations. The main part of the document describes the different positions a fetus can take during labor, including occiput posterior. It provides details on identifying and managing different positions and presentations, including mechanisms of labor, signs and symptoms on examination, and potential interventions if needed.
Fetal malpositioning & malpresentation can pose a serious threat to maternal & fetal well being. The document discusses the risks, complication, and management of some of the common malpresentation & malpositioning.
this is the first part of my FACE PRESENTATION.this ppt contains all the required content for a face presentation and mechanism of labour in face presntation and also for diagnosis i uploaded another ppt. the main objective of my ppt is the viewers shouldn't get bored of what we say this is simplified yet professional .. have a look at it and enjoy, thank you.
Fetal malpositioning & malpresentation can pose a serious threat to maternal & fetal well being. The document discusses the risks, complication, and management of some of the common malpresentation & malpositioning.
this is the first part of my FACE PRESENTATION.this ppt contains all the required content for a face presentation and mechanism of labour in face presntation and also for diagnosis i uploaded another ppt. the main objective of my ppt is the viewers shouldn't get bored of what we say this is simplified yet professional .. have a look at it and enjoy, thank you.
Comparing Evolved Extractive Text Summary Scores of Bidirectional Encoder Rep...University of Maribor
Slides from:
11th International Conference on Electrical, Electronics and Computer Engineering (IcETRAN), Niš, 3-6 June 2024
Track: Artificial Intelligence
https://www.etran.rs/2024/en/home-english/
Slide 1: Title Slide
Extrachromosomal Inheritance
Slide 2: Introduction to Extrachromosomal Inheritance
Definition: Extrachromosomal inheritance refers to the transmission of genetic material that is not found within the nucleus.
Key Components: Involves genes located in mitochondria, chloroplasts, and plasmids.
Slide 3: Mitochondrial Inheritance
Mitochondria: Organelles responsible for energy production.
Mitochondrial DNA (mtDNA): Circular DNA molecule found in mitochondria.
Inheritance Pattern: Maternally inherited, meaning it is passed from mothers to all their offspring.
Diseases: Examples include Leber’s hereditary optic neuropathy (LHON) and mitochondrial myopathy.
Slide 4: Chloroplast Inheritance
Chloroplasts: Organelles responsible for photosynthesis in plants.
Chloroplast DNA (cpDNA): Circular DNA molecule found in chloroplasts.
Inheritance Pattern: Often maternally inherited in most plants, but can vary in some species.
Examples: Variegation in plants, where leaf color patterns are determined by chloroplast DNA.
Slide 5: Plasmid Inheritance
Plasmids: Small, circular DNA molecules found in bacteria and some eukaryotes.
Features: Can carry antibiotic resistance genes and can be transferred between cells through processes like conjugation.
Significance: Important in biotechnology for gene cloning and genetic engineering.
Slide 6: Mechanisms of Extrachromosomal Inheritance
Non-Mendelian Patterns: Do not follow Mendel’s laws of inheritance.
Cytoplasmic Segregation: During cell division, organelles like mitochondria and chloroplasts are randomly distributed to daughter cells.
Heteroplasmy: Presence of more than one type of organellar genome within a cell, leading to variation in expression.
Slide 7: Examples of Extrachromosomal Inheritance
Four O’clock Plant (Mirabilis jalapa): Shows variegated leaves due to different cpDNA in leaf cells.
Petite Mutants in Yeast: Result from mutations in mitochondrial DNA affecting respiration.
Slide 8: Importance of Extrachromosomal Inheritance
Evolution: Provides insight into the evolution of eukaryotic cells.
Medicine: Understanding mitochondrial inheritance helps in diagnosing and treating mitochondrial diseases.
Agriculture: Chloroplast inheritance can be used in plant breeding and genetic modification.
Slide 9: Recent Research and Advances
Gene Editing: Techniques like CRISPR-Cas9 are being used to edit mitochondrial and chloroplast DNA.
Therapies: Development of mitochondrial replacement therapy (MRT) for preventing mitochondrial diseases.
Slide 10: Conclusion
Summary: Extrachromosomal inheritance involves the transmission of genetic material outside the nucleus and plays a crucial role in genetics, medicine, and biotechnology.
Future Directions: Continued research and technological advancements hold promise for new treatments and applications.
Slide 11: Questions and Discussion
Invite Audience: Open the floor for any questions or further discussion on the topic.
(May 29th, 2024) Advancements in Intravital Microscopy- Insights for Preclini...Scintica Instrumentation
Intravital microscopy (IVM) is a powerful tool utilized to study cellular behavior over time and space in vivo. Much of our understanding of cell biology has been accomplished using various in vitro and ex vivo methods; however, these studies do not necessarily reflect the natural dynamics of biological processes. Unlike traditional cell culture or fixed tissue imaging, IVM allows for the ultra-fast high-resolution imaging of cellular processes over time and space and were studied in its natural environment. Real-time visualization of biological processes in the context of an intact organism helps maintain physiological relevance and provide insights into the progression of disease, response to treatments or developmental processes.
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Deep Behavioral Phenotyping in Systems Neuroscience for Functional Atlasing a...Ana Luísa Pinho
Functional Magnetic Resonance Imaging (fMRI) provides means to characterize brain activations in response to behavior. However, cognitive neuroscience has been limited to group-level effects referring to the performance of specific tasks. To obtain the functional profile of elementary cognitive mechanisms, the combination of brain responses to many tasks is required. Yet, to date, both structural atlases and parcellation-based activations do not fully account for cognitive function and still present several limitations. Further, they do not adapt overall to individual characteristics. In this talk, I will give an account of deep-behavioral phenotyping strategies, namely data-driven methods in large task-fMRI datasets, to optimize functional brain-data collection and improve inference of effects-of-interest related to mental processes. Key to this approach is the employment of fast multi-functional paradigms rich on features that can be well parametrized and, consequently, facilitate the creation of psycho-physiological constructs to be modelled with imaging data. Particular emphasis will be given to music stimuli when studying high-order cognitive mechanisms, due to their ecological nature and quality to enable complex behavior compounded by discrete entities. I will also discuss how deep-behavioral phenotyping and individualized models applied to neuroimaging data can better account for the subject-specific organization of domain-general cognitive systems in the human brain. Finally, the accumulation of functional brain signatures brings the possibility to clarify relationships among tasks and create a univocal link between brain systems and mental functions through: (1) the development of ontologies proposing an organization of cognitive processes; and (2) brain-network taxonomies describing functional specialization. To this end, tools to improve commensurability in cognitive science are necessary, such as public repositories, ontology-based platforms and automated meta-analysis tools. I will thus discuss some brain-atlasing resources currently under development, and their applicability in cognitive as well as clinical neuroscience.
What is greenhouse gasses and how many gasses are there to affect the Earth.moosaasad1975
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Observation of Io’s Resurfacing via Plume Deposition Using Ground-based Adapt...Sérgio Sacani
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A brief information about the SCOP protein database used in bioinformatics.
The Structural Classification of Proteins (SCOP) database is a comprehensive and authoritative resource for the structural and evolutionary relationships of proteins. It provides a detailed and curated classification of protein structures, grouping them into families, superfamilies, and folds based on their structural and sequence similarities.
2. Fetal presenting part other than vertex includes
breech, face, brow, transverse, and compound
presentation.
3. More than one pregnancy (e.g. Multipara,Grand multipara )
More than one fetus (e.g. Twins)
Too much or too little amniotic fluid (e.g. Polyhydramnious,
oligohydramnios)
Abnormal uterine shape (e.g. Arcuate ,septate, supseptate) or
abnormal growth (e.g Fibroid)
Placenta previa
The baby is preterm
4. Presentation
the part of the fetus which occupying the
lower uterine segment
Presentation may be :
(3%)
(0.5%)
Breech
Face
Brow
Shoulder
Compound
3 in 100
1 in 500
1 in 1000
1 in 300
1 in 1000
(0.3%)
8. The occiput is in the posterior segment of pelvis,
overlying the sacroiliac joint or the sacrum
Occipitoposterior position is responsible for most cases
of prolonged labour and second stage delay and is the
most common cause of a mobile head at term
When the occiput is in front of the sacrum, it is termed
direct Occipitoposterior
In the right Occipitoposterior, the occiput overlies the
right sacroiliac joint and in left Occipitoposterior, it
overlies the left sacroiliac joint
Thus,3 positions are described –ROP, LOP, Direct
Occipitoposterior
9.
10.
11. 1. BACK ON THE RIGHT SIDE
If the back is to the left as in 70% of vertex presentations, the
chance of a posterior position(LOP) is remote
this is because of dextrorotation of uterus and the presence of
sigmoid colon on the left
the foetal back is seen on the right side in 25-30% of vertex
presentations and this predisposes to occipitoposterior(ROP)
2. ANTERIOR INSERTION OF PLACENTA
Favours a posterior position by pushing the back of the head
with the broader biparietal diameter posteriorly
12. 3. SHAPE OF THE BRIM
Influences position
In anthropoid pelvis, the anteroposterior diameter of
the brim exceeds the transverse diameter
This pelvis is usually of high assimilation type with an
extra vertebra in the sacrum
Therefore, inclination of the pelvis is increased and this
favours Occipitoposterior
In android pelvis, the inlet is wedge shaped and so the
bulky occiput cannot find space in the narrow forepelvis
This also predisposes to Occipitoposterior
13. ABDOMINAL EXAMINATION
Subumbilical flattening due to the absence of the back
anteriorly
Back is in one or the other flank and so cannot be felt
clearly
Limbs are felt easily anteriorly
Shoulder is felt out in the flanks
Unengaged or high head at term
The sinciput and occiput may be at the same level due
to deflexion
Fetal heart sounds are heard in the flanks and are
frequently indistinct
14. VAGINAL EXAMINATION
Early in Labour
Early rupture of conical bag of membranes
Sagittal suture in the right oblique diameter of the
pelvis
Smaller posterior fontanelle in the right posterior
quadrant and diamond shaped larger anterior
fontanelle in the left anterior quadrant
As the head is deflexed, both fontanelles are easily
palpated
15. In occipitoanterior position, as the head is well
flexed, the posterior fontanelle will be easily
felt, but not the anterior fontanelle
On the other hand, in Occipitoposterior, the
head is usually deflexed and so the anterior
fontanelle will also be felt with ease
16. LATE IN LABOUR
A large caput may be present obscuring the sutures
The pinna always points the occiput
Perineum gapes much before the head distends it
and premature straining can occur
Difficulty in applying forceps in unrecognised
occipitoposterior
17. Occipitoposterior position is the common
cause for prolonged labour in a vertex
presentation
The mechanism of labour will depend upon
whether the vertex is well flexed. in
occipitoposterior position with a well flexed
head, the occiput being the lower will touch the
pelvic floor first and rotate anteriorly and
labour proceeds normally
18. However due to the longer internal rotation in
occipitoposterior(3/8 of a circle) labour will
naturally be prolonged
In some occipitoposterior positions, the head is
deflexed and this may result in further delay in
rotation or malrotation
19. Deflexion may be due to when the back is
posterior, the convexity of the fetal spine abuts
against the convexity of the maternal spine causing
extension of the head
Hence large diameter present to the pelvic inlet
and the occiput is no longer the leading part. This
is also known as relative disproportion
Another problem is that in OPP, the biparietal
diameter occupies the smaller sacrocotyloid
diameter which is encroached upon by the sacral
promontory
And hence the labour is further arrested
20. Suboccipitofrontal diameter in a deflexed head
is 10.5cm
Occipitofrontal diameter in a head which is
further deflexed is 11.5cm
21. 1. Anterior rotation
In 90% of cases, the occiput rotates anteriorly through
3/8of a circle and the baby is born as occipitoanterior.
Engagement may be delayed and labour may be longer
because of the dorsiflexion
2. Posterior rotation and face to pubis delvery
When the head is deflexed, the engaging diameter is the
occipitofrontal and sinciput is the leading part. Hence
the sinciput touches the pelvic floor first and rotates
anteriorly. The occiput thus rotates posteriorly into the
hollow of sacrum and delivery occurs as face to pubis.
e
B
x
i
r
t
t
e
h
n
i
s
s
i
o
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yextreme flexion followed by extreme
22. Perineal tears are common as the occiput is
posterior and it is the longer biparietal
diameter(9.4), which distends the perineum rather
than the smaller bitemporal(8cm). Hence liberal
episiotomy should be given.
3. Failure of rotation
Per
rotation
sistent
and
occi
the
pitopost
head
erior is the a
b
s
e
n
c
e
of
remains ROP or LOP
Deep
ste
re
ar
tr
d
ansve
with
rs
the
e ar
sag
rest is defined
as the head being
diameter at the level
ittal suture
in the transverse
dilatation of cervix
of
ischial spine, after full
contractions.
and in spite of
good uterine
23. REASONS FOR FAILURE OF ROTATION
Deflexion of the head
Inefficient uterine contraction
Weak pelvic floor preventing anterior rotation
Cephalopelvic disproportion and android
pelvis
24. Most of the malposition will rotate anteriorly and
the baby will be born spontaneously as occiput
anterior
Alternatively, the may rotate posteriorly and
deliver as face to pubis which need liberal
episiotomy.
As the labour is longer, judicious use of fluids and
analgesia is needed.
Epidural analgesia is ideal.
26. 1. CAESAREAN SECTION
The pelvis should be reassessed and if the pelvis is
android or there is evidence of disproportion,
CAESAREAN SECTION should be done
Increasing use of caesarean for deep transverse
arrest is to avoid the intracranial haemorrhage due
to traumatic vaginal delivery
27. 2. VACCUM EXTRACTION
This is an alternative in the absence of
cephalopelvic disproportion.
It promotes flexion thereby reducing the diameter
presenting to the outlet from occipitofrontal to
smaller suboccipitobrgmatic.
It is less traumatic and does not need general
anaesthesia
The cup should be applied as near posterior
fontanelle as possible as in order to promote flexion
and smooth descent .
28. 3. MANUAL ROTATION
This procedure can be employed if the obstetrician
is well versed in this technique.
Under the general anaesthesia, the right hand
grasps the sinciput displacing it thereby increasing
flexion.
The smaller bitemporal diameter allows more space
for the thumb and finger to have a firm grasp
across the temple with middle finger on the frontal
suture. In LOP, the left hand is used. Then the
sinciput is rotated and forceps or vaccum is applied
29. 4. FORCEPS ROTATION
In deep transverse arrest Keilland forceps is used.
It should be used only by the obstetrician who are
expert in its use.
It is widely used in UK but it is not popular in India.
Keilland forceps is applied under General
Anaesthesia in the anteroposterior direction and
rotation carried out
30.
31. This is a cephalic presentation where the attitude is one
of complete extension, presenting part is the face (area
between chin and glabella)and denominator is the chin
or mentum.
Primary face presentation: present before the onset of
labour and are rare
Secondary face presentation: caused by extension
during labour.( E.g. . left mentoanterior is a result of
extension of right Occipitoposterior)
34. Maternal
Contracted pelvis
Oblique of uterus
Multiparity and pendulous abdomen
Fetal
Anencephaly and iniencephlaly
Cord round neck
Tumor of neck like congenital goiter
Spasm of sternocleidomastoid muscle
Dolichocephalic head
35. Abdominal examination
In mentoanterior, back is felt with difficulty as it is
posterior and limbs are felt anteriorly
Head remains high
Cephalic prominence is the occiput and on the
same side as the back
Groove between the head and back is prominent
Fetal heart sound are transmited through the chest
and heart well anteriorly in mentoanterior
36. Vaginal examination
Conrical bag of membranes
Chin, mouth, nose, mala eminences, and
supraorbital ridges are felt
In mentoanterior, chin is in one anterior quadrant
and forehead in the opposite posterior quadrant
37. Mentoanterior posterior
1. Engagement
the engagement diameter is submentobregmatic.
In face presentation, the biparietal diameter is 7 cm
behind the face unlike in vertex, where it is only 3-4
cm distance.
The biparietal diameter will pass through the inlet
only when the face is low down in the perineum.
When the face is distending the vulva (crowning),
the head has just engaged.
38. 2. Descent with increasing extension
Descent is brought by the same factors as in vertex
presentation.
When resistance is encountered by a process of
extension, the occiput is pushed towards the back
of the fetus, while the chin descents.
39. 3. Internal rotation
On further descent, the chin reach
0
es the pelvic floor
and rotates anteriorly through 45 towards the
symphysis.
Anterior rotation does not take place until the face
is well applied to the pelvic floor and may be
delayed. Only internal rotation takes place this
manner, can the neck travers the posterior surface
of the symphysis pubis.
40. 4. flexion
The head is born by flexion. The chin pivots under
the symphysis pubis and the mouth, nose, orbits,
forehead, vertex and occiput are born by flexion
5.Restitution and external rotation
Restitution and external rotation of chin occurs
towards the side to which it was originally directed,
and the shoulder are born as in vertex
41. Mentoposterior position
2/3 of cases anteriorly through 3/8 of a circle
and deliver as mentoanterior. Of the rest, some
remain in the oblique diameter and some
rotate posteriorly into the hollow of sacrum.
In these cases of persistent mentoposterior, the
neck is too short to span the 12cm of the
anterior aspect of sacrum.
42. The shoulder also get impacted along with the
head making delivery impossible.
The engaging diameter is the sternobregmatic,
which is about 17cm. Hence, there is no
mechanism of labour in mentoposterior
43. Cause of prolonged labour in face
Face is less effective dilator of cervix
No moulding of face
More chance of premature rupture of membrane
Long internal rotation in mentoposterior
Internal rotation occurs only late in the second
stage
44. complication
prolonged and complicated labour
Maternal distress … dehydration …
Infection
obstructed labour → uterine rupture
→maternal death
Fetal
complication
Rupture of fetal membranes
cord prolapse → fetal distress →fetal death
edema of the brow
marked moulding , congenital malformation
Increase in maternal and fetal morbidity and mortality
Maternal
complication
45. Evaluate the cephalopelvic disproportion or
other associated complication and in such
situation, caesarian section is done.
If there is no disproportion and position is
mentoanterior, labour can be allowed to
progress.
In persistent mentoposterior, cescerian section
is done.
46.
47. It is the least common among cephalic
presentation and most unfavorable.
The attitude is one of partial extension , the
presenting part being the area between the
anterior fontanelle(bregma) above and the
glabella and orbital ridges bellow and
denominator is the forehead or frontum.
51. - Left fronto-anterior.
- Right fronto-anterior.
- Right fronto-posterior.
- Left fronto-posterior.
52. Abdominal examination
High mobile head, which feels large from side to
side
Cephalic prominence is the occiput and is on the
same side as the back and the groove between the
cephalic prominence and the back is less prominent
than in face presentation
53. Vaginal examination
Conical bag of membrane may be felt in early
labour
Anterior fontanelle(bregma) is felt at one end and
root of nose(nasion)and orbit ridges at the other
end of an oblique or transvers diameter.
Sometimes, the nose and the mouth are palpable,
but not the chin.
54. As such, ther is no mechanism of labour for
persistent brow presentation.
Spontaneous delivery is unlikely and can occur
only when there is a very small baby and large
pelvis.
In persistent brow, the verticomental diameter
is shortened and the occipitofrontal diameter is
elongated with marked moulding and a large
catput on the forehead
55.
56. complication
Increase in maternal and fetal morbidity and mortality
Maternal complication
prolonged and complicated labour
Maternal distress … dehydration … keto acidosis
Infection
No engagement of presenting part
obstructed labour → uterine rupture →maternal death
fetal complication
Rupture of fetal membranes
cord prolapse → fetal distress →fetal death
marked molding
57. Antepartum
It is better to wait until the onset of labour in the
hope that correction to vertex or face.
Early labour
Cesarean section should be done. If diagnosis in
early labour before rupture of membrane, a short
period of time can be given under close supervision
in the hope of spontaneous correction.
58. Late labour
It there is feature of obstructed labour, cesarean
section is performed immediately even if the fetus is
dead.