Term for relation of different pas of the fetus to one another: September 2009, March 2013
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Fetal attitude
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Ans. B: Fetal Attitude Fetal station: This is the relationship between the presenting pa of the baby- the head, shoulder, buttocks, or feet and two pas of the mother's pelvis called the ischial spines. Normally the ischial spines are the narrowest pa of the pelvis. They are a natural measuring point for the delivery progress. If the presenting pa lies above the ischial spines, the station is repoed as a negative number from -1 to -5 (each number is a centimeter). If the presenting pa lies below the ischial spines, the station is repoed as a positive number from +1 to +5. The baby is said to be "engaged" in the pelvis when it is even with the ischial spines at 0 station. Fetal lie: This is the relationship between the head to tailbone axis of the fetus and the head to tailbone axis of the mother. If the two are parallel, then the fetus is said to be in a longitudinal lie. If the two are at 90-degree angles to each other, the fetus is said to be in a transverse lie. Nearly all (99.5%) fetuses are in a longitudinal lie. Fetal attitude: The fetal attitude describes the relationship of the fetus' body pas to one another. The normal fetal attitude is commonly referred to as the fetal position. The head is tucked down to the chest, with arms and legs drawn in towards the center of the chest. Abnormal fetal attitudes may include a head that is extended back or other body pas extended or positioned behind the back. Abnormal fetal attitudes can increase the diameter of the presenting pa as it passes through the pelvis, increasing the difficulty of bih. Fetal presentation: The presenting pa is defined as the pa of the presentation which overlies the internal os. - Cephalic (head-first) presentation: - Cephalic presentation is considered normal and occurs in about 97% of deliveries. There are different types of cephalic presentation, which depend on the fetal attitude. Rarely, the fetus' head is extended back, and the chin, face, or forehead will present first depending on the degree of extension. This is a more difficult delivery, because this is not the smallest pa of the fetus' head. It may result in a need for cesarean delivery. A cesarean delivery may be recommended for any of the fetal positions other than cephalic. Breech presentation: Breech presentation is considered abnormal and occurs about 3% of the time. A complete breech presentation occurs when the buttocks present first, and both the hips and knees are flexed. A frank breech occurs when the hips are flexed so the legs are straight and completely drawn up toward the chest. Other breech positions occur when either the feet or knees come out first. Shoulder presentation: The shoulder, arm, or trunk may present first if the fetus is in a transverse lie. This type of presentation occurs less than 1% of the time. Transverse lie is more common with premature delivery or multiple pregnancies.
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