MCN 273 FINAL EXAM: YOUR A+ GUIDE THROUGH
QUESTIONS AND ANSWERS.
Birth Passageway
Bony pelvis - pelvic inlet nad outlet
Pelvic shape - gynecoid and anthropoid favored
Soft tissues - ability of cervix to dilate, efface, ability of vaginal canal to distant
Birth Passenger
Fetal head, attitude, lie, presentation
Fetal Head
Face/cranium base are fixed
Cranial vault is pliable (bony plates can overlap)
Frontal, parietal, occipital bones (overlapping bones = molding)
Fetal Head Diameters
Suboccipitobregmatic ~9.5cm from back of skull to the anterior fontanelle
Variable, should be coming in with chin to chest
Biparietal ~9.25cm - side of baby's head
Sutures
Membraneous joints uniting cranial bones
Allow for molding
Sagittal and cranial
Where the sagittal and cranial meet is the anterior fontanelle which will tell you which way the
baby is coming down/facing
Fetal Attitude
Relation of the fetal body parts to one another
Posture of fetus to conform to uterine cavity
Normal attitude = general flexion, head flexed, chin to chest, arms crossed over chest, legs
flexed at knee, thighs on abdomen
Abnormal lie = extension
Fetal Lie
Relationship of fetal spinal column to that of mother
Cephalocaudal axis
Longitudinal 98% = vertical (parallel to maternal spine), cephalic or breech
Transverse 2% = horizontal, shoulder presentation
,Fetal Presentation
Presenting part of the body that enters the pelvis first
Normal is cephalic presentation (aka vertex = very top of head)
Fetal Malpresentation
Cephalic (brow, face) - brow is considered the presenting state
Breech 3% of all births
Frank 50-70% come in in a pike position, legs straight up
Incomplete/footing 10-30% one foot or two feet out first
Complete 5010% cannonball position, legs tucked in
Shoulder transverse 2% of all births
Compound - head and hand, two parts presenting
Cephalic (Brow): Presenting Part
Forehead (extended head)
Cephalic (Brow): Contributing Causes
Uterine anomaly
High parity
Low birth weight
Pelvic shape
Cephalic (Brow): Maternal Risk
Prolonged labor
C/S
Episiotomy
Cephalic (Brow): Fetal Fisk
Birth Injury
Cephalic (Brow): Clinical Therapy
None indicated if labor is progression
C/S if not
Cephalic (Face): Presenting Part
Face (hyperextended head)
Cephalic (Face): Contributing Causes
Uterine anomaly
High parity
, Low birth weight
Pelvic shape
Cephalic (Face): Maternal Risk
Prolonged labor
C/S
Episiotomy
Cephalic (Face): Fetal Risk
Edema/bruising of face, head, and airway
Cephalic (Face): Clinical Therapy
C/S typical recommended
Vaginal delivery possible in some cases
Breech: Presenting Part
Sacrum or feet
Breech: Contributing Causes
Previa (placental previa = low implantation of placenta
Uterine anomaly
High parity
Multiples
Prematurity (small babies have too much space to move around)
Previous breech
Breech: Fetal Risk
Cord prolapse
Head entrapment
Neuromuscular disorders
Breech: Clinical Therapy
External cephalic version (try to et baby to flip by pushing on belly)
C/S
CAM (Moxibustion-mugwart which is supposed to stimulate fetal movement, burn it close
towards feet)
Transverse: Presenting Part
Shoulder
Transverse: Contributing Causes
QUESTIONS AND ANSWERS.
Birth Passageway
Bony pelvis - pelvic inlet nad outlet
Pelvic shape - gynecoid and anthropoid favored
Soft tissues - ability of cervix to dilate, efface, ability of vaginal canal to distant
Birth Passenger
Fetal head, attitude, lie, presentation
Fetal Head
Face/cranium base are fixed
Cranial vault is pliable (bony plates can overlap)
Frontal, parietal, occipital bones (overlapping bones = molding)
Fetal Head Diameters
Suboccipitobregmatic ~9.5cm from back of skull to the anterior fontanelle
Variable, should be coming in with chin to chest
Biparietal ~9.25cm - side of baby's head
Sutures
Membraneous joints uniting cranial bones
Allow for molding
Sagittal and cranial
Where the sagittal and cranial meet is the anterior fontanelle which will tell you which way the
baby is coming down/facing
Fetal Attitude
Relation of the fetal body parts to one another
Posture of fetus to conform to uterine cavity
Normal attitude = general flexion, head flexed, chin to chest, arms crossed over chest, legs
flexed at knee, thighs on abdomen
Abnormal lie = extension
Fetal Lie
Relationship of fetal spinal column to that of mother
Cephalocaudal axis
Longitudinal 98% = vertical (parallel to maternal spine), cephalic or breech
Transverse 2% = horizontal, shoulder presentation
,Fetal Presentation
Presenting part of the body that enters the pelvis first
Normal is cephalic presentation (aka vertex = very top of head)
Fetal Malpresentation
Cephalic (brow, face) - brow is considered the presenting state
Breech 3% of all births
Frank 50-70% come in in a pike position, legs straight up
Incomplete/footing 10-30% one foot or two feet out first
Complete 5010% cannonball position, legs tucked in
Shoulder transverse 2% of all births
Compound - head and hand, two parts presenting
Cephalic (Brow): Presenting Part
Forehead (extended head)
Cephalic (Brow): Contributing Causes
Uterine anomaly
High parity
Low birth weight
Pelvic shape
Cephalic (Brow): Maternal Risk
Prolonged labor
C/S
Episiotomy
Cephalic (Brow): Fetal Fisk
Birth Injury
Cephalic (Brow): Clinical Therapy
None indicated if labor is progression
C/S if not
Cephalic (Face): Presenting Part
Face (hyperextended head)
Cephalic (Face): Contributing Causes
Uterine anomaly
High parity
, Low birth weight
Pelvic shape
Cephalic (Face): Maternal Risk
Prolonged labor
C/S
Episiotomy
Cephalic (Face): Fetal Risk
Edema/bruising of face, head, and airway
Cephalic (Face): Clinical Therapy
C/S typical recommended
Vaginal delivery possible in some cases
Breech: Presenting Part
Sacrum or feet
Breech: Contributing Causes
Previa (placental previa = low implantation of placenta
Uterine anomaly
High parity
Multiples
Prematurity (small babies have too much space to move around)
Previous breech
Breech: Fetal Risk
Cord prolapse
Head entrapment
Neuromuscular disorders
Breech: Clinical Therapy
External cephalic version (try to et baby to flip by pushing on belly)
C/S
CAM (Moxibustion-mugwart which is supposed to stimulate fetal movement, burn it close
towards feet)
Transverse: Presenting Part
Shoulder
Transverse: Contributing Causes
