NCM 109: PROBLEMS WITH THE PASSENGER
(COMPLETE)
Occipitoposterior position (OP) - Answers - - The most common malposition
- the occiput of the baby is in the posterior portion (baby faces front of the mom)
- NSVD is possible but assoc. with longer and painful labor
Occipitoanterior position (OA) - Answers - - ideal fetal position for faster labor
Face Presentation - Answers - the face as the first presenting part at the vaginal
opening during birth
Brow Presentation - Answers - The fetal head is partly extended. The longest diameter
of the fetal head is presenting. This presentation is unstable and tends to convert to
either a vertex or a face presentation.
Vertex Presentation - Answers - the baby is head down and is delivered head first
- Ideal presentation
Breech Presentation (Definition) - Answers - birth position in which the buttocks, feet,
or knees emerge first
Breech Presentation (Assessment) - Answers - The presentation is not important
before the 32nd to 36th week.
Lower uterus: soft, irregular mass.
Fundal area: firm, smooth, rounded mass.
Auscultation: Fetal heartbeat is loudest above the umbilicus.
Breech Presentation (Types) - Answers - Frank Breech : butt down, feet pointed up
toward head
Footling Breech: one or two feet foot down
Complete breech: Breech with flexed leg; Hips and knee are flexed.
Breech Presentation (Maternal Risks) - Answers - ● Gestational age of <40 wks.
(could be managed)
● Fetal abnormality
● Polyhydramnios
● Mid Septum in the uterus
● Tumor growth in the uterus (prevent fetus to position correctly)
● Pendulous abdomen
● Multiple gestation
Breech birth (Definition) - Answers - not common; done by skilled health care provider
with safe condition; there should be complete or frank breech presentation
, - meconium staining is normal in this position
Breech birth (Considerations) - Answers - ➢ does not have a history of CPD
➢ no complications such as fetal growth restriction
➢ uterine bleeding
➢ previous cesarean delivery
➢ fetal abnormalities
➢ twin pregnancy
➢ hypertension
➢ fetal death
External Cephalic Version (Definition and Considerations) - Answers - Turning a
breech baby to cephalic presentation through the maternal abdominal wall
- use anesthesia as it is painful
- make sure uterus is not contracting
- only attempt if breechj presentation is present at/after 37wks
External Cephalic Version (Contraindications) - Answers - ➢ Extended fetal leg
➢ Placental implantation
➢ Contracted maternal pelvis
➢ Tumor certain fetal anomaly (hydrocephaly)
➢ Teratoma
➢ Multiple Gestation
Shoulder Presentation (Definition) - Answers - long axis of baby's body is across the
long axis of the mother's body; shoulder is presented at the cervical opening
- contraindication for NSVD, must be rotated or perform CS
Shoulder Presentation (Maternal Risks) - Answers - ● Pendulous abdomen
● Uterine fibroid tumors
● Congenital abnormality in the uterus
● Premature infant
Fetal Distress (Definition) - Answers - - defined as depletion of oxygen and
accumulation of carbon dioxide, leading to a state of hypoxia and acidosis.
- May result in permanent fetal brain damage or death.
Fetal Distress (Maternal Factors) - Answers - PIH
Low oxygen carried by RBC
Placenta Previa & abruptio placenta
(COMPLETE)
Occipitoposterior position (OP) - Answers - - The most common malposition
- the occiput of the baby is in the posterior portion (baby faces front of the mom)
- NSVD is possible but assoc. with longer and painful labor
Occipitoanterior position (OA) - Answers - - ideal fetal position for faster labor
Face Presentation - Answers - the face as the first presenting part at the vaginal
opening during birth
Brow Presentation - Answers - The fetal head is partly extended. The longest diameter
of the fetal head is presenting. This presentation is unstable and tends to convert to
either a vertex or a face presentation.
Vertex Presentation - Answers - the baby is head down and is delivered head first
- Ideal presentation
Breech Presentation (Definition) - Answers - birth position in which the buttocks, feet,
or knees emerge first
Breech Presentation (Assessment) - Answers - The presentation is not important
before the 32nd to 36th week.
Lower uterus: soft, irregular mass.
Fundal area: firm, smooth, rounded mass.
Auscultation: Fetal heartbeat is loudest above the umbilicus.
Breech Presentation (Types) - Answers - Frank Breech : butt down, feet pointed up
toward head
Footling Breech: one or two feet foot down
Complete breech: Breech with flexed leg; Hips and knee are flexed.
Breech Presentation (Maternal Risks) - Answers - ● Gestational age of <40 wks.
(could be managed)
● Fetal abnormality
● Polyhydramnios
● Mid Septum in the uterus
● Tumor growth in the uterus (prevent fetus to position correctly)
● Pendulous abdomen
● Multiple gestation
Breech birth (Definition) - Answers - not common; done by skilled health care provider
with safe condition; there should be complete or frank breech presentation
, - meconium staining is normal in this position
Breech birth (Considerations) - Answers - ➢ does not have a history of CPD
➢ no complications such as fetal growth restriction
➢ uterine bleeding
➢ previous cesarean delivery
➢ fetal abnormalities
➢ twin pregnancy
➢ hypertension
➢ fetal death
External Cephalic Version (Definition and Considerations) - Answers - Turning a
breech baby to cephalic presentation through the maternal abdominal wall
- use anesthesia as it is painful
- make sure uterus is not contracting
- only attempt if breechj presentation is present at/after 37wks
External Cephalic Version (Contraindications) - Answers - ➢ Extended fetal leg
➢ Placental implantation
➢ Contracted maternal pelvis
➢ Tumor certain fetal anomaly (hydrocephaly)
➢ Teratoma
➢ Multiple Gestation
Shoulder Presentation (Definition) - Answers - long axis of baby's body is across the
long axis of the mother's body; shoulder is presented at the cervical opening
- contraindication for NSVD, must be rotated or perform CS
Shoulder Presentation (Maternal Risks) - Answers - ● Pendulous abdomen
● Uterine fibroid tumors
● Congenital abnormality in the uterus
● Premature infant
Fetal Distress (Definition) - Answers - - defined as depletion of oxygen and
accumulation of carbon dioxide, leading to a state of hypoxia and acidosis.
- May result in permanent fetal brain damage or death.
Fetal Distress (Maternal Factors) - Answers - PIH
Low oxygen carried by RBC
Placenta Previa & abruptio placenta
