Scribd
Upload
2K views10 pages

Compound Presentation

This document discusses different fetal positions and presentations that can occur during labor and delivery, including: - Compound presentation, where the fetal head and an extremity present simultaneously. - Breech presentations, where the buttocks or feet present first, including frank breech, complete breech, footling breech, and kneeling breech. - Transverse/shoulder lie, where the fetal back or shoulder presents across the maternal pelvis. It provides details on diagnosing and distinguishing between these presentations, as well as complications that can arise for both mother and baby if the presentation is not optimal for vaginal delivery. Management plans are outlined depending on the presentation and status of labor.

Uploaded by

maezu
Copyright
© © All Rights Reserved
We take content rights seriously. If you suspect this is your content, claim it here.
Available Formats
Download as PPTX, PDF, TXT or read online on Scribd
2K views10 pages

Compound Presentation

This document discusses different fetal positions and presentations that can occur during labor and delivery, including: - Compound presentation, where the fetal head and an extremity present simultaneously. - Breech presentations, where the buttocks or feet present first, including frank breech, complete breech, footling breech, and kneeling breech. - Transverse/shoulder lie, where the fetal back or shoulder presents across the maternal pelvis. It provides details on diagnosing and distinguishing between these presentations, as well as complications that can arise for both mother and baby if the presentation is not optimal for vaginal delivery. Management plans are outlined depending on the presentation and status of labor.

Uploaded by

maezu
Copyright
© © All Rights Reserved
We take content rights seriously. If you suspect this is your content, claim it here.
Available Formats
Download as PPTX, PDF, TXT or read online on Scribd

Compound

presentation
An extremity, usually the hand
occurs alongside
the fetal head inside the pelvis
simultaneously

Breech
presentation
tal buttock and/ or feet are the presenting

The fe

Diagnosis
Abdominal findings
Head is felt in the upper part of the uterus
Breech is in the pelvic brim
Fetal heart auscultated above the umbilicus
Vaginal findings
Buttock or feet is felt
Unlike face presentation, the anal orifice is
inline with the trochanteric eminences
Frank breech: Both hips are flexed while both
knees are extended. Neither of the feet is felt.
Complete breech: Both hips and knees are
flexed. If the feet are felt, they are placed above
the buttock.
Footling breech: One or both hips are extended
with one or both extended knee(s) and the foot
felt below the buttocks
Kneeling breech: One or both knee(s) are
extended with flexed knee(s) and the knee feltpart

Frank breech
Complete breech
Footling breech

Transverse lie (shoulder


presentation

Diagnosis
Abdominal findings
Neither the fetal head or breech are felt in the
upper and lower part of the uterus
The abdomen is transversely elongated than
longitudinally
Fundal height is less than gestation
Vaginal findings
The shoulder or the prolapsed arm is felt

Complication
Labor:

Prolonged labor
Obstructed labor
Maternal:
Operative deliveries: CS, laparotomy, operative vaginal deliveries
Complication of prolonged and obstructed labor (ruptured uterus,
fistula etc)
Bleeding: genital trauma, abnormal placentation, and uterine
atony
Infection: prolonged labor, PROM, genital trauma, frequent vaginal
examinations
Increased maternal mortality and morbidity

Fetal:
Asphyxia
Umbilical cord prolapse
PROM
Increased operative deliveries
Trauma: increased perinatal mortality and morbidity
Treatment plan
Malpresentation and malposition leading to prolonged and
obstructed labor (see section
on abnormal labor and obstructed labor). The following plan
summarizes the preobstructed
labor with live-fetus management. The management detail of
breech is
described in the next sections on breech presentations

Obstructed Labor and Ruptured


Uterus

Definition
Obstructed labor (OL) is failure of descent of the fetus in the birth canal for
mechanical reasons in spite of good uterine contractions22.
Spontaneous rupture of the uterus is rupture of the unscarred uterus
following
obstructed labor usually in the multigravida or oxytocin use.
In complete uterine rupture, all the three layers of the uterus are involved
and there is
a direct communication between the uterine and abdominal cavities. In
incomplete
uterine rupture the peritoneum covering the uterus remains intact. A rare
variety of
uterine rupture is one that involves the serosa and the external myometrium,
but the
laceration does not extend into the uterine cavity23.
Trial of labor is a planned and closely monitored labor to achieve safe
vaginal
delivery in cases of suspected CPD. The trial is not allowed till complications
of OL
take place.

You might also like