A 26-year-old G2P1 woman at 41 weeks gestation has been pushing for 3 hours without progress. Throughout this time, her vaginal examination has remained completely dilated, completely effaced, and 0 station, with the head persistently in the occiput posterior position. Which of the following statements accurately describes the situation
Correct Answer: The patient is best described as having an arrest of descent.
Description: A 3-hour second stage of labor still is abnormal, even with epidural analgesia. An anthropoid pelvis, which predisposes to the persistent fetal occiput posterior position, is characterized by a pelvis with an anteroposterior diameter greater than the transverse diameter with prominent ischial spines and a narrow anterior segment. The baby is at "0" station, meaning that the presenting pa (in most cases, the bony pa of the fetal head) is right at the plane of the ischial spines and not at the pelvic inlet. Station refers to the relationship of the presenting bony pa of the fetal head in relation to the ischial spines, and not the pelvic inlet. Engagement refers to the relationship of the widest diameter of the presenting pa and its location with reference to the pelvic inlet. Manual rotation of the fetal head may be considered in selected circumstances.<img alt="" src=" />
Category:
Gynaecology & Obstetrics
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