Presentation in Obstetrics refers to the relationship between the leading fetal part and the pelvic inlet: cephalic, breech, or shoulder presentation. A malpresentation is an abnormal (non-vertex) presentation.
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Classification
Thus the various presentations are:
- Cephalic presentation (Head first):
- Vertex —commonest and associated with least complications
- Sinciput (forehead)
- Brow (Eye brows)
- Face
- Chin
- Breech presentation[1] (Baby is oriented up-side-down with mother standing):
- Complete breech
- Footling breech
- Frank breech
- Shoulder presentation
- Arm
- Shoulder
- Trunk
Related obstetrical terms
Attitude
- Definition: Relationship of fetal head to spine:
- flexed, (this is the normal situation)
- neutral (“military”),
- extende.
Position
- Definition: Relationship of presenting part to maternal pelvis: and based on presentation:
- Cephalic presentation
- Vertex presentation with longitudinal lie:[1]
- Left occipitoanterior (LOA)—the occiput is close to the vagina (hence known as vertex presentation) faces anteriorly (forward with mother standing) and towards left. This is the most common position and lie.
- Right occipitoanterior (ROA)—the occiput faces anteriorly and towards right. Less common than LOA, but not associated with labor complications.
- Left occipitoposterior (LOP)—the occiput faces posteriorly (behind) and towards left.
- Right occipitoposterior (ROP)—the occiput faces posteriorly and towards 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
- Vertex presentation with longitudinal lie:[1]
- Cephalic presentation
-
- Breech presentation with longitudinal lie:[1]
- Left sacrum anterior (LSA)—the buttocks, as against the occiput of the vertex presentation, like close to the vagina (hence known as breech presentation), which like anteriorly and towards the left.
- Right sacrum anterior (RSA)—the buttocks face anteriorly and towards the right.
- Left sacrum posterior (LSP)—the buttocks face posteriorly and towards the left.
- Right sacrum posterior (RSP)—the buttocks face posteriorly and towards right.
- Sacrum anterior(SA)—the buttocks face anteriorly.
- Sacrum posterior (SP)—the buttocks face posteriorly.
- Breech presentation with longitudinal lie:[1]
-
- Shoulder presentation with transverse lie are classified into four types, based on the location of the scapula (shoulderblade); note: this presentation needs to be delivered by cesarean section.
- Left scapula-anterior (LSA)
- Right scapula-anterior (RSA)
- Left scapula-posterior (LSP)
- Right scapula-posterior (RSP)
- Shoulder presentation with transverse lie are classified into four types, based on the location of the scapula (shoulderblade); note: this presentation needs to be delivered by cesarean section.
Lie
- Definition: Relationship between the longitudinal axis of fetus and mother:
- longitudinal, (resulting in either cephalic or breech presentation)
- oblique, (unstable, will eventually become either transverse or longitudinal)
- transverse (resulting in shoulder presentation).
See also
References
- ^ a b c Kish, Karen; Joseph V. Collea (2003). "Malpresentation & Cord Prolapse (Chapter 21)". in Alan H. DeCherney. Current Obstetric & Gynecologic Diagnosis & Treatment. Lauren Nathan (Ninth Edition ed.). Lange/McGraw-Hill. pp. 369. ISBN 0-07-118207-1.
External links
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