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obstetrics Obstetrics is the field of study concentrated on pregnancy, childbirth and the postpartum period. As a medical specialty, obstetrics is combined with gynecology under the discipline known as obstetrics and gynecology (OB/GYN), which is a sur ...
, the presentation of a
fetus A fetus or foetus (; plural fetuses, feti, foetuses, or foeti) is the unborn offspring that develops from an animal embryo. Following embryonic development the fetal stage of development takes place. In human prenatal development, fetal dev ...
about to be born specifies which anatomical part of the fetus is leading, that is, is closest to the pelvic inlet of the birth canal. According to the leading part, this is identified as a cephalic,
breech Breech may refer to: * Breech (firearms), the opening at the rear of a gun barrel where the cartridge is inserted in a breech-loading weapon * breech, the lower part of a pulley block * breech, the penetration of a boiler where exhaust gases leave ...
, or
shoulder The human shoulder is made up of three bones: the clavicle (collarbone), the scapula (shoulder blade), and the humerus (upper arm bone) as well as associated muscles, ligaments and tendons. The articulations between the bones of the shoulder mak ...
presentation. A malpresentation is any presentation other than a vertex presentation (with the top of the head first).


Classification

Thus the various presentations are: *
cephalic presentation A cephalic presentation or head presentation or head-first presentation is a situation at childbirth where the fetus is in a longitudinal lie and the head enters the pelvis first; the most common form of cephalic presentation is the vertex p ...
(head first): ** vertex (
crown A crown is a traditional form of head adornment, or hat, worn by monarchs as a symbol of their power and dignity. A crown is often, by extension, a symbol of the monarch's government or items endorsed by it. The word itself is used, partic ...
)—the most common and associated with the fewest complications ** sinciput (forehead) ** brow (eyebrows) ** face ** chin *
breech presentation A breech birth is when a baby is born bottom first instead of head first, as is normal. Around 3–5% of pregnant women at term (37–40 weeks pregnant) have a breech baby. Due to their higher than average rate of possible complications for the ...
(buttocks or feet first): ** complete breech ** footling breech ** frank breech * shoulder presentation: **arm **shoulder **trunk *compound presentation—when any other part presents along with the fetal head


Related obstetrical terms


Attitude

* Definition: Relationship of fetal head to spine: **flexed, (this is the normal situation) **neutral ("military"), **extended. **hyperextended


Position

* Relationship of presenting part to maternal pelvis based on presentation. The fetus enters the pelvis in the occipito-transverse plane (left or right), descent, and flexion and then rotates 90 degrees to the occipitoanterior (most commonly). **
Cephalic presentation A cephalic presentation or head presentation or head-first presentation is a situation at childbirth where the fetus is in a longitudinal lie and the head enters the pelvis first; the most common form of cephalic presentation is the vertex p ...
*** Vertex presentation with longitudinal lie: ****Left occipitoanterior (LOA)—the occiput is close to the vagina (hence known as vertex presentation), facing anteriorly (forward with mother standing) and toward the left. This is the most common position and lie. ****Right occipitoanterior (ROA)—the occiput faces anteriorly and toward the right. Less common than LOA, but not associated with labor complications. ****Left occipitoposterior (LOP)—the occiput faces posteriorly (behind) and toward the left. ****Right occipitoposterior (ROP)—the occiput faces posteriorly and toward the right. ****Occipitoanterior—the occiput faces anteriorly (absolutely straight without any turning to any of the sides) ****Occipitoposterior—the occiput faces posteriorly (absolutely straight without any turning to any of the sides) *** Face presentation ****Mentum anterior—the fetal chin is in the direction of the maternal pubic symphysis. ****Mentum posterior—the fetal chin is in the direction of the maternal sacrum. This presentation is not compatible with vaginal delivery. **
Breech presentation A breech birth is when a baby is born bottom first instead of head first, as is normal. Around 3–5% of pregnant women at term (37–40 weeks pregnant) have a breech baby. Due to their higher than average rate of possible complications for the ...
with longitudinal lie: ***Left
sacrum The sacrum (plural: ''sacra'' or ''sacrums''), in human anatomy, is a large, triangular bone at the base of the spine that forms by the fusing of the sacral vertebrae (S1S5) between ages 18 and 30. The sacrum situates at the upper, back part o ...
anterior (LSA)—the buttocks, as against the occiput of the vertex presentation, lie close to the vagina (hence known as breech presentation), which lie anteriorly and toward the left. ***Right sacrum anterior (RSA)—the buttocks face anteriorly and toward the right. ***Left sacrum posterior (LSP)—the buttocks face posteriorly and toward the left. ***Right sacrum posterior (RSP)—the buttocks face posteriorly and toward the right. ***Sacrum anterior (SA)—the buttocks face anteriorly. ***Sacrum posterior (SP)—the buttocks face posteriorly. ** Shoulder presentations with transverse lie are classified into four types, based on the location of the
scapula The scapula (plural scapulae or scapulas), also known as the shoulder blade, is the bone that connects the humerus (upper arm bone) with the clavicle (collar bone). Like their connected bones, the scapulae are paired, with each scapula on eith ...
(shoulder blade). This presentation needs to be delivered by
cesarean section Caesarean section, also known as C-section or caesarean delivery, is the surgical procedure by which one or more babies are delivered through an incision in the mother's abdomen, often performed because vaginal delivery would put the baby or ...
. ***Left scapula-anterior (LSA) ***Right scapula-anterior (RSA) ***Left scapula-posterior (LSP) ***Right scapula-posterior (RSP)


Lie

* Definition: Relationship between the longitudinal axis of fetus and mother: **longitudinal (resulting in either cephalic or breech presentation) **oskie (cephalic presentation, fetus legs straight along frontal axis of mother) **oblique (unstable, will eventually become either transverse or longitudinal) **transverse (resulting in shoulder presentation) ***back up ***back down (indication for vertical uterine incision during cesarean delivery)


See also

*
Child birth Childbirth, also known as labour and delivery, is the ending of pregnancy where one or more babies exits the internal environment of the mother via vaginal delivery or caesarean section. In 2019, there were about 140.11 million births globa ...
* Eucharius Rösslin * Fetal relations * Position


References


External links


Malpresentations and malpositions: A guide for midwives and doctors
by the
WHO Who or WHO may refer to: * Who (pronoun), an interrogative or relative pronoun * Who?, one of the Five Ws in journalism * World Health Organization Arts and entertainment Fictional characters * Who, a creature in the Dr. Seuss book '' Horton He ...

''Normal Labor and Delivery'' from Management of Labor and Delivery provided by Google books
{{Pregnancy Presentations and positions in childbirth Obstetrics Midwifery