Presentation (obstetrics)
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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 su ...
, the presentation of a
fetus A fetus or foetus (; : fetuses, foetuses, rarely feti or foeti) is the unborn offspring of a viviparous animal that develops from an embryo. Following the embryonic development, embryonic stage, the fetal stage of development takes place. Pren ...
about to be
born Born may refer to: * Childbirth * Born (surname), a surname (see also for a list of people with the name) * ''Born'' (comics), a comic book limited series Places * Born, Belgium, a village in the German-speaking Community of Belgium * Born, Luxe ...
specifies which anatomical part of the fetus is leading, that is, is closest to the
pelvic inlet The pelvic inlet or superior aperture of the pelvis is a planar surface which defines the boundary between the pelvic cavity and the abdominal cavity (or, according to some authors, between two parts of the pelvic cavity, called lesser pelvis an ...
of the
birth canal In mammals and other animals, the vagina (: vaginas or vaginae) is the elastic, muscular reproductive organ of the female genital tract. In humans, it extends from the vulval vestibule to the cervix (neck of the uterus). The vaginal int ...
. According to the leading part, this is identified as a
cephalic A head is the part of an organism which usually includes the ears, brain, forehead, cheeks, chin, eyes, nose, and mouth, each of which aid in various sensory functions such as sight, hearing, smell, and taste. Some very simple animals may no ...
, breech, 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 m ...
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 In obstetrics, a cephalic presentation or head presentation or head-first presentation is a situation at childbirth where the fetus is in a presentation (obstetrics), longitudinal lie and the Human head, head enters the pelvis first; the most ...
(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, parti ...
)—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 Cephalic presentation, 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 ...
(buttocks or feet first): ** complete breech ** footling breech ** frank breech *
shoulder presentation In obstetrics, a shoulder presentation is a malpresentation at childbirth where the baby is in a transverse lie (its vertebral column is perpendicular to that of the mother), thus the leading part (the part that first enters the birth canal) is ...
: **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 In obstetrics, a cephalic presentation or head presentation or head-first presentation is a situation at childbirth where the fetus is in a presentation (obstetrics), longitudinal lie and the Human head, head enters the pelvis first; the most ...
*** Vertex presentation with longitudinal lie: ****Left occipitoanterior (LOA)—the
occiput The occipital bone () is a cranial dermal bone and the main bone of the occiput (back and lower part of the skull). It is trapezoidal in shape and curved on itself like a shallow dish. The occipital bone lies over the occipital lobes of the ...
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 Cephalic presentation, 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 ...
with longitudinal lie: ***Left
sacrum The sacrum (: sacra or sacrums), in human anatomy, is a 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 of the pelvic cavity, ...
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 presentation In obstetrics, a shoulder presentation is a malpresentation at childbirth where the baby is in a transverse lie (its vertebral column is perpendicular to that of the mother), thus the leading part (the part that first enters the birth canal) is ...
s with transverse lie are classified into four types, based on the location of the
scapula The scapula (: 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 either side ...
(shoulder blade). This presentation needs to be delivered by
cesarean section Caesarean section, also known as C-section, cesarean, or caesarean delivery, is the surgical procedure by which one or more babies are delivered through an incision in the mother's abdomen. It is often performed because vaginal delivery would ...
. ***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) **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, parturition and delivery, is the completion of pregnancy, where one or more fetuses exits the internal environment of the mother via vaginal delivery or caesarean section and becomes a newborn to the world ...
* Eucharius Rösslin * Fetal relations *
Position Position often refers to: * Position (geometry), the spatial location (rather than orientation) of an entity * Position, a job or occupation Position may also refer to: Games and recreation * Position (poker), location relative to the dealer * ...


References


External links


Malpresentations and malpositions: A guide for midwives and doctors
by the
WHO The World Health Organization (WHO) is a specialized agency of the United Nations which coordinates responses to international public health issues and emergencies. It is headquartered in Geneva, Switzerland, and has 6 regional offices and 15 ...

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