Normal Labor Lectures 4 N.Petrenko, MD, PhD
Dec 21, 2015
Normal Labor
Lectures 4NPetrenko MD PhD
1 Birth Passage
1 Birth Passage
1 Birth Passage
1 Birth Passage
brim Cavity Outlet
Transverse 131 125 118
Oblique 125 131 118
Anteroposterior
113 131 125
1 Birth Passage
Four different types of pelvises but frequently mixed types
gynaecoidanthrapoid android
platypelloid
Pelvic inletsGynecoid
Platypoid
Anthropoid Android
1 Birth Passage
1 Birth Passage
1 Birth Passage
1 Birth Passage
1 Birth PassageAsymmetrical pelvises
Abnormality of lower limbAbnormality of pelvic girdleAbnormality of vertebral column
Robertrsquos pelvisOsteomalacic pelvis
Scoliotic pelvisCoxalgic pelvis
Split pelvis Naegelersquos pelvis
1 Birth Passage
Measurement of AP conjugatesbullDiagonal conjugate ~120 cmbullTrue conjugate ~110 cmbullAP outlet ~125 cm
1 Birth Passage
Assess shape of sacrum
2 FetusSutures
Frontal
Sagittal
Coronal
Lambdoidal
Frontal suture
Sagittal suture
Coronal suture
Lambdoidal suture
Note sutures are actually membranous spaces that meet at fontanels
1 Bones 2 parietals 2 frontals 2 temporals occipital2 Sutures sagital frontal lamboidal coronal temporal3 Fontanelles anterior posterior 2 anterior temporals 2 posterior temporals
Foetal skull
Fetal skull
1 Suboccipitobregamatic ~95 cc Vertex2 Suboccipitofrontal ~100 cm Sinciput3 Occipitofrontal~1124 cm persistent OP4 Mentovertical ~138 cm brow5 Submentobregmatic ~95 cm Face6 Submentovertical ~1125 cm incompletelyextended face7 Biparietal diameter ~95 cm
1
2
3
5
6
7
4
Fetus
Fontanelles intersection of sutures allows for molding helps identify position of head
Anterior (bregma)Diamond shaped
Approx 2-3 cm
Ossifies in ~12-18 months
PosteriorTriangle shaped
Smaller
Closes in 8-12 weeks
Fetus Fetal lie
Longitudinal
Transverse
Fetus Fetal lie
Cephalic
Shoulder
Breech
Fetus
Fetal presentation Cephalic
Vertex presentationMost common
Head completely flexed on chest
Suboccipitobregmatic (Smallest diameter)
Occiput in presenting part
Fetus
Fetal presentation CephalicMilitary presentation
Fetal head neither flexed nor extended
Occipitofrontal diameter presents
Top of the head is presenting part
Fetus
Fetal presentation Cephalic
Brow presentationFetal head partially extended
Occipitomental diameter presents
Sinciput is presenting part
Fetus
Fetal presentation Cephalic
Face presentationHead hyperextended
Submentobregmatic diameter presents
Face is presenting part
Fetal presentations
FetusFetal presentation Breech
Sacrum is the landmark
Complete breechKnees and hips are flexed thighs on abdomen (ldquofetal positionrdquo)
Buttocks and feet are presenting parts
FetusFetal presentation Breech
Sacrum is the landmark
Frank breechHips flexed knees extended
Buttocks is presenting part
FetusFetal presentation Breech
Sacrum is the landmark
Footling breechHips and legs extended
Feet are presenting parts (single vs double)
FetusFetal presentation Shoulder
Acromion process of shoulder is presenting part
Station
Station of the head inrelation to ischial spines
1048713In Gynaecoid amp Android pelvis distance between ischial spine to brim is ~5 cm1048713In Anthropoid pelvis distance is ~7 cm1048713In Platypelloid pelvis distance is ~3 cm
Relationship of maternal pelvis and presenting part
Normal uterine action
Normal uterine action
True vs False LaborTrue False
Contractions
Regular uarrfrequency duration intensity
Irregular short duration mild
Pain Starts in back radiates to front
Begins in abdomen
Cervix change
Dilationeffacement No change
Cont change
Does not decrease with rest or warm bath walking makes stronger
Decreases with rest warm bath walking slows
Partogram
Alert line
Acton line
Normal dilatation
Abnormal dilatation
Stages of
Labor
Stages of Labor
1 Birth Passage
1 Birth Passage
1 Birth Passage
1 Birth Passage
brim Cavity Outlet
Transverse 131 125 118
Oblique 125 131 118
Anteroposterior
113 131 125
1 Birth Passage
Four different types of pelvises but frequently mixed types
gynaecoidanthrapoid android
platypelloid
Pelvic inletsGynecoid
Platypoid
Anthropoid Android
1 Birth Passage
1 Birth Passage
1 Birth Passage
1 Birth Passage
1 Birth PassageAsymmetrical pelvises
Abnormality of lower limbAbnormality of pelvic girdleAbnormality of vertebral column
Robertrsquos pelvisOsteomalacic pelvis
Scoliotic pelvisCoxalgic pelvis
Split pelvis Naegelersquos pelvis
1 Birth Passage
Measurement of AP conjugatesbullDiagonal conjugate ~120 cmbullTrue conjugate ~110 cmbullAP outlet ~125 cm
1 Birth Passage
Assess shape of sacrum
2 FetusSutures
Frontal
Sagittal
Coronal
Lambdoidal
Frontal suture
Sagittal suture
Coronal suture
Lambdoidal suture
Note sutures are actually membranous spaces that meet at fontanels
1 Bones 2 parietals 2 frontals 2 temporals occipital2 Sutures sagital frontal lamboidal coronal temporal3 Fontanelles anterior posterior 2 anterior temporals 2 posterior temporals
Foetal skull
Fetal skull
1 Suboccipitobregamatic ~95 cc Vertex2 Suboccipitofrontal ~100 cm Sinciput3 Occipitofrontal~1124 cm persistent OP4 Mentovertical ~138 cm brow5 Submentobregmatic ~95 cm Face6 Submentovertical ~1125 cm incompletelyextended face7 Biparietal diameter ~95 cm
1
2
3
5
6
7
4
Fetus
Fontanelles intersection of sutures allows for molding helps identify position of head
Anterior (bregma)Diamond shaped
Approx 2-3 cm
Ossifies in ~12-18 months
PosteriorTriangle shaped
Smaller
Closes in 8-12 weeks
Fetus Fetal lie
Longitudinal
Transverse
Fetus Fetal lie
Cephalic
Shoulder
Breech
Fetus
Fetal presentation Cephalic
Vertex presentationMost common
Head completely flexed on chest
Suboccipitobregmatic (Smallest diameter)
Occiput in presenting part
Fetus
Fetal presentation CephalicMilitary presentation
Fetal head neither flexed nor extended
Occipitofrontal diameter presents
Top of the head is presenting part
Fetus
Fetal presentation Cephalic
Brow presentationFetal head partially extended
Occipitomental diameter presents
Sinciput is presenting part
Fetus
Fetal presentation Cephalic
Face presentationHead hyperextended
Submentobregmatic diameter presents
Face is presenting part
Fetal presentations
FetusFetal presentation Breech
Sacrum is the landmark
Complete breechKnees and hips are flexed thighs on abdomen (ldquofetal positionrdquo)
Buttocks and feet are presenting parts
FetusFetal presentation Breech
Sacrum is the landmark
Frank breechHips flexed knees extended
Buttocks is presenting part
FetusFetal presentation Breech
Sacrum is the landmark
Footling breechHips and legs extended
Feet are presenting parts (single vs double)
FetusFetal presentation Shoulder
Acromion process of shoulder is presenting part
Station
Station of the head inrelation to ischial spines
1048713In Gynaecoid amp Android pelvis distance between ischial spine to brim is ~5 cm1048713In Anthropoid pelvis distance is ~7 cm1048713In Platypelloid pelvis distance is ~3 cm
Relationship of maternal pelvis and presenting part
Normal uterine action
Normal uterine action
True vs False LaborTrue False
Contractions
Regular uarrfrequency duration intensity
Irregular short duration mild
Pain Starts in back radiates to front
Begins in abdomen
Cervix change
Dilationeffacement No change
Cont change
Does not decrease with rest or warm bath walking makes stronger
Decreases with rest warm bath walking slows
Partogram
Alert line
Acton line
Normal dilatation
Abnormal dilatation
Stages of
Labor
Stages of Labor
1 Birth Passage
1 Birth Passage
1 Birth Passage
brim Cavity Outlet
Transverse 131 125 118
Oblique 125 131 118
Anteroposterior
113 131 125
1 Birth Passage
Four different types of pelvises but frequently mixed types
gynaecoidanthrapoid android
platypelloid
Pelvic inletsGynecoid
Platypoid
Anthropoid Android
1 Birth Passage
1 Birth Passage
1 Birth Passage
1 Birth Passage
1 Birth PassageAsymmetrical pelvises
Abnormality of lower limbAbnormality of pelvic girdleAbnormality of vertebral column
Robertrsquos pelvisOsteomalacic pelvis
Scoliotic pelvisCoxalgic pelvis
Split pelvis Naegelersquos pelvis
1 Birth Passage
Measurement of AP conjugatesbullDiagonal conjugate ~120 cmbullTrue conjugate ~110 cmbullAP outlet ~125 cm
1 Birth Passage
Assess shape of sacrum
2 FetusSutures
Frontal
Sagittal
Coronal
Lambdoidal
Frontal suture
Sagittal suture
Coronal suture
Lambdoidal suture
Note sutures are actually membranous spaces that meet at fontanels
1 Bones 2 parietals 2 frontals 2 temporals occipital2 Sutures sagital frontal lamboidal coronal temporal3 Fontanelles anterior posterior 2 anterior temporals 2 posterior temporals
Foetal skull
Fetal skull
1 Suboccipitobregamatic ~95 cc Vertex2 Suboccipitofrontal ~100 cm Sinciput3 Occipitofrontal~1124 cm persistent OP4 Mentovertical ~138 cm brow5 Submentobregmatic ~95 cm Face6 Submentovertical ~1125 cm incompletelyextended face7 Biparietal diameter ~95 cm
1
2
3
5
6
7
4
Fetus
Fontanelles intersection of sutures allows for molding helps identify position of head
Anterior (bregma)Diamond shaped
Approx 2-3 cm
Ossifies in ~12-18 months
PosteriorTriangle shaped
Smaller
Closes in 8-12 weeks
Fetus Fetal lie
Longitudinal
Transverse
Fetus Fetal lie
Cephalic
Shoulder
Breech
Fetus
Fetal presentation Cephalic
Vertex presentationMost common
Head completely flexed on chest
Suboccipitobregmatic (Smallest diameter)
Occiput in presenting part
Fetus
Fetal presentation CephalicMilitary presentation
Fetal head neither flexed nor extended
Occipitofrontal diameter presents
Top of the head is presenting part
Fetus
Fetal presentation Cephalic
Brow presentationFetal head partially extended
Occipitomental diameter presents
Sinciput is presenting part
Fetus
Fetal presentation Cephalic
Face presentationHead hyperextended
Submentobregmatic diameter presents
Face is presenting part
Fetal presentations
FetusFetal presentation Breech
Sacrum is the landmark
Complete breechKnees and hips are flexed thighs on abdomen (ldquofetal positionrdquo)
Buttocks and feet are presenting parts
FetusFetal presentation Breech
Sacrum is the landmark
Frank breechHips flexed knees extended
Buttocks is presenting part
FetusFetal presentation Breech
Sacrum is the landmark
Footling breechHips and legs extended
Feet are presenting parts (single vs double)
FetusFetal presentation Shoulder
Acromion process of shoulder is presenting part
Station
Station of the head inrelation to ischial spines
1048713In Gynaecoid amp Android pelvis distance between ischial spine to brim is ~5 cm1048713In Anthropoid pelvis distance is ~7 cm1048713In Platypelloid pelvis distance is ~3 cm
Relationship of maternal pelvis and presenting part
Normal uterine action
Normal uterine action
True vs False LaborTrue False
Contractions
Regular uarrfrequency duration intensity
Irregular short duration mild
Pain Starts in back radiates to front
Begins in abdomen
Cervix change
Dilationeffacement No change
Cont change
Does not decrease with rest or warm bath walking makes stronger
Decreases with rest warm bath walking slows
Partogram
Alert line
Acton line
Normal dilatation
Abnormal dilatation
Stages of
Labor
Stages of Labor
1 Birth Passage
1 Birth Passage
brim Cavity Outlet
Transverse 131 125 118
Oblique 125 131 118
Anteroposterior
113 131 125
1 Birth Passage
Four different types of pelvises but frequently mixed types
gynaecoidanthrapoid android
platypelloid
Pelvic inletsGynecoid
Platypoid
Anthropoid Android
1 Birth Passage
1 Birth Passage
1 Birth Passage
1 Birth Passage
1 Birth PassageAsymmetrical pelvises
Abnormality of lower limbAbnormality of pelvic girdleAbnormality of vertebral column
Robertrsquos pelvisOsteomalacic pelvis
Scoliotic pelvisCoxalgic pelvis
Split pelvis Naegelersquos pelvis
1 Birth Passage
Measurement of AP conjugatesbullDiagonal conjugate ~120 cmbullTrue conjugate ~110 cmbullAP outlet ~125 cm
1 Birth Passage
Assess shape of sacrum
2 FetusSutures
Frontal
Sagittal
Coronal
Lambdoidal
Frontal suture
Sagittal suture
Coronal suture
Lambdoidal suture
Note sutures are actually membranous spaces that meet at fontanels
1 Bones 2 parietals 2 frontals 2 temporals occipital2 Sutures sagital frontal lamboidal coronal temporal3 Fontanelles anterior posterior 2 anterior temporals 2 posterior temporals
Foetal skull
Fetal skull
1 Suboccipitobregamatic ~95 cc Vertex2 Suboccipitofrontal ~100 cm Sinciput3 Occipitofrontal~1124 cm persistent OP4 Mentovertical ~138 cm brow5 Submentobregmatic ~95 cm Face6 Submentovertical ~1125 cm incompletelyextended face7 Biparietal diameter ~95 cm
1
2
3
5
6
7
4
Fetus
Fontanelles intersection of sutures allows for molding helps identify position of head
Anterior (bregma)Diamond shaped
Approx 2-3 cm
Ossifies in ~12-18 months
PosteriorTriangle shaped
Smaller
Closes in 8-12 weeks
Fetus Fetal lie
Longitudinal
Transverse
Fetus Fetal lie
Cephalic
Shoulder
Breech
Fetus
Fetal presentation Cephalic
Vertex presentationMost common
Head completely flexed on chest
Suboccipitobregmatic (Smallest diameter)
Occiput in presenting part
Fetus
Fetal presentation CephalicMilitary presentation
Fetal head neither flexed nor extended
Occipitofrontal diameter presents
Top of the head is presenting part
Fetus
Fetal presentation Cephalic
Brow presentationFetal head partially extended
Occipitomental diameter presents
Sinciput is presenting part
Fetus
Fetal presentation Cephalic
Face presentationHead hyperextended
Submentobregmatic diameter presents
Face is presenting part
Fetal presentations
FetusFetal presentation Breech
Sacrum is the landmark
Complete breechKnees and hips are flexed thighs on abdomen (ldquofetal positionrdquo)
Buttocks and feet are presenting parts
FetusFetal presentation Breech
Sacrum is the landmark
Frank breechHips flexed knees extended
Buttocks is presenting part
FetusFetal presentation Breech
Sacrum is the landmark
Footling breechHips and legs extended
Feet are presenting parts (single vs double)
FetusFetal presentation Shoulder
Acromion process of shoulder is presenting part
Station
Station of the head inrelation to ischial spines
1048713In Gynaecoid amp Android pelvis distance between ischial spine to brim is ~5 cm1048713In Anthropoid pelvis distance is ~7 cm1048713In Platypelloid pelvis distance is ~3 cm
Relationship of maternal pelvis and presenting part
Normal uterine action
Normal uterine action
True vs False LaborTrue False
Contractions
Regular uarrfrequency duration intensity
Irregular short duration mild
Pain Starts in back radiates to front
Begins in abdomen
Cervix change
Dilationeffacement No change
Cont change
Does not decrease with rest or warm bath walking makes stronger
Decreases with rest warm bath walking slows
Partogram
Alert line
Acton line
Normal dilatation
Abnormal dilatation
Stages of
Labor
Stages of Labor
1 Birth Passage
brim Cavity Outlet
Transverse 131 125 118
Oblique 125 131 118
Anteroposterior
113 131 125
1 Birth Passage
Four different types of pelvises but frequently mixed types
gynaecoidanthrapoid android
platypelloid
Pelvic inletsGynecoid
Platypoid
Anthropoid Android
1 Birth Passage
1 Birth Passage
1 Birth Passage
1 Birth Passage
1 Birth PassageAsymmetrical pelvises
Abnormality of lower limbAbnormality of pelvic girdleAbnormality of vertebral column
Robertrsquos pelvisOsteomalacic pelvis
Scoliotic pelvisCoxalgic pelvis
Split pelvis Naegelersquos pelvis
1 Birth Passage
Measurement of AP conjugatesbullDiagonal conjugate ~120 cmbullTrue conjugate ~110 cmbullAP outlet ~125 cm
1 Birth Passage
Assess shape of sacrum
2 FetusSutures
Frontal
Sagittal
Coronal
Lambdoidal
Frontal suture
Sagittal suture
Coronal suture
Lambdoidal suture
Note sutures are actually membranous spaces that meet at fontanels
1 Bones 2 parietals 2 frontals 2 temporals occipital2 Sutures sagital frontal lamboidal coronal temporal3 Fontanelles anterior posterior 2 anterior temporals 2 posterior temporals
Foetal skull
Fetal skull
1 Suboccipitobregamatic ~95 cc Vertex2 Suboccipitofrontal ~100 cm Sinciput3 Occipitofrontal~1124 cm persistent OP4 Mentovertical ~138 cm brow5 Submentobregmatic ~95 cm Face6 Submentovertical ~1125 cm incompletelyextended face7 Biparietal diameter ~95 cm
1
2
3
5
6
7
4
Fetus
Fontanelles intersection of sutures allows for molding helps identify position of head
Anterior (bregma)Diamond shaped
Approx 2-3 cm
Ossifies in ~12-18 months
PosteriorTriangle shaped
Smaller
Closes in 8-12 weeks
Fetus Fetal lie
Longitudinal
Transverse
Fetus Fetal lie
Cephalic
Shoulder
Breech
Fetus
Fetal presentation Cephalic
Vertex presentationMost common
Head completely flexed on chest
Suboccipitobregmatic (Smallest diameter)
Occiput in presenting part
Fetus
Fetal presentation CephalicMilitary presentation
Fetal head neither flexed nor extended
Occipitofrontal diameter presents
Top of the head is presenting part
Fetus
Fetal presentation Cephalic
Brow presentationFetal head partially extended
Occipitomental diameter presents
Sinciput is presenting part
Fetus
Fetal presentation Cephalic
Face presentationHead hyperextended
Submentobregmatic diameter presents
Face is presenting part
Fetal presentations
FetusFetal presentation Breech
Sacrum is the landmark
Complete breechKnees and hips are flexed thighs on abdomen (ldquofetal positionrdquo)
Buttocks and feet are presenting parts
FetusFetal presentation Breech
Sacrum is the landmark
Frank breechHips flexed knees extended
Buttocks is presenting part
FetusFetal presentation Breech
Sacrum is the landmark
Footling breechHips and legs extended
Feet are presenting parts (single vs double)
FetusFetal presentation Shoulder
Acromion process of shoulder is presenting part
Station
Station of the head inrelation to ischial spines
1048713In Gynaecoid amp Android pelvis distance between ischial spine to brim is ~5 cm1048713In Anthropoid pelvis distance is ~7 cm1048713In Platypelloid pelvis distance is ~3 cm
Relationship of maternal pelvis and presenting part
Normal uterine action
Normal uterine action
True vs False LaborTrue False
Contractions
Regular uarrfrequency duration intensity
Irregular short duration mild
Pain Starts in back radiates to front
Begins in abdomen
Cervix change
Dilationeffacement No change
Cont change
Does not decrease with rest or warm bath walking makes stronger
Decreases with rest warm bath walking slows
Partogram
Alert line
Acton line
Normal dilatation
Abnormal dilatation
Stages of
Labor
Stages of Labor
1 Birth Passage
Four different types of pelvises but frequently mixed types
gynaecoidanthrapoid android
platypelloid
Pelvic inletsGynecoid
Platypoid
Anthropoid Android
1 Birth Passage
1 Birth Passage
1 Birth Passage
1 Birth Passage
1 Birth PassageAsymmetrical pelvises
Abnormality of lower limbAbnormality of pelvic girdleAbnormality of vertebral column
Robertrsquos pelvisOsteomalacic pelvis
Scoliotic pelvisCoxalgic pelvis
Split pelvis Naegelersquos pelvis
1 Birth Passage
Measurement of AP conjugatesbullDiagonal conjugate ~120 cmbullTrue conjugate ~110 cmbullAP outlet ~125 cm
1 Birth Passage
Assess shape of sacrum
2 FetusSutures
Frontal
Sagittal
Coronal
Lambdoidal
Frontal suture
Sagittal suture
Coronal suture
Lambdoidal suture
Note sutures are actually membranous spaces that meet at fontanels
1 Bones 2 parietals 2 frontals 2 temporals occipital2 Sutures sagital frontal lamboidal coronal temporal3 Fontanelles anterior posterior 2 anterior temporals 2 posterior temporals
Foetal skull
Fetal skull
1 Suboccipitobregamatic ~95 cc Vertex2 Suboccipitofrontal ~100 cm Sinciput3 Occipitofrontal~1124 cm persistent OP4 Mentovertical ~138 cm brow5 Submentobregmatic ~95 cm Face6 Submentovertical ~1125 cm incompletelyextended face7 Biparietal diameter ~95 cm
1
2
3
5
6
7
4
Fetus
Fontanelles intersection of sutures allows for molding helps identify position of head
Anterior (bregma)Diamond shaped
Approx 2-3 cm
Ossifies in ~12-18 months
PosteriorTriangle shaped
Smaller
Closes in 8-12 weeks
Fetus Fetal lie
Longitudinal
Transverse
Fetus Fetal lie
Cephalic
Shoulder
Breech
Fetus
Fetal presentation Cephalic
Vertex presentationMost common
Head completely flexed on chest
Suboccipitobregmatic (Smallest diameter)
Occiput in presenting part
Fetus
Fetal presentation CephalicMilitary presentation
Fetal head neither flexed nor extended
Occipitofrontal diameter presents
Top of the head is presenting part
Fetus
Fetal presentation Cephalic
Brow presentationFetal head partially extended
Occipitomental diameter presents
Sinciput is presenting part
Fetus
Fetal presentation Cephalic
Face presentationHead hyperextended
Submentobregmatic diameter presents
Face is presenting part
Fetal presentations
FetusFetal presentation Breech
Sacrum is the landmark
Complete breechKnees and hips are flexed thighs on abdomen (ldquofetal positionrdquo)
Buttocks and feet are presenting parts
FetusFetal presentation Breech
Sacrum is the landmark
Frank breechHips flexed knees extended
Buttocks is presenting part
FetusFetal presentation Breech
Sacrum is the landmark
Footling breechHips and legs extended
Feet are presenting parts (single vs double)
FetusFetal presentation Shoulder
Acromion process of shoulder is presenting part
Station
Station of the head inrelation to ischial spines
1048713In Gynaecoid amp Android pelvis distance between ischial spine to brim is ~5 cm1048713In Anthropoid pelvis distance is ~7 cm1048713In Platypelloid pelvis distance is ~3 cm
Relationship of maternal pelvis and presenting part
Normal uterine action
Normal uterine action
True vs False LaborTrue False
Contractions
Regular uarrfrequency duration intensity
Irregular short duration mild
Pain Starts in back radiates to front
Begins in abdomen
Cervix change
Dilationeffacement No change
Cont change
Does not decrease with rest or warm bath walking makes stronger
Decreases with rest warm bath walking slows
Partogram
Alert line
Acton line
Normal dilatation
Abnormal dilatation
Stages of
Labor
Stages of Labor
Pelvic inletsGynecoid
Platypoid
Anthropoid Android
1 Birth Passage
1 Birth Passage
1 Birth Passage
1 Birth Passage
1 Birth PassageAsymmetrical pelvises
Abnormality of lower limbAbnormality of pelvic girdleAbnormality of vertebral column
Robertrsquos pelvisOsteomalacic pelvis
Scoliotic pelvisCoxalgic pelvis
Split pelvis Naegelersquos pelvis
1 Birth Passage
Measurement of AP conjugatesbullDiagonal conjugate ~120 cmbullTrue conjugate ~110 cmbullAP outlet ~125 cm
1 Birth Passage
Assess shape of sacrum
2 FetusSutures
Frontal
Sagittal
Coronal
Lambdoidal
Frontal suture
Sagittal suture
Coronal suture
Lambdoidal suture
Note sutures are actually membranous spaces that meet at fontanels
1 Bones 2 parietals 2 frontals 2 temporals occipital2 Sutures sagital frontal lamboidal coronal temporal3 Fontanelles anterior posterior 2 anterior temporals 2 posterior temporals
Foetal skull
Fetal skull
1 Suboccipitobregamatic ~95 cc Vertex2 Suboccipitofrontal ~100 cm Sinciput3 Occipitofrontal~1124 cm persistent OP4 Mentovertical ~138 cm brow5 Submentobregmatic ~95 cm Face6 Submentovertical ~1125 cm incompletelyextended face7 Biparietal diameter ~95 cm
1
2
3
5
6
7
4
Fetus
Fontanelles intersection of sutures allows for molding helps identify position of head
Anterior (bregma)Diamond shaped
Approx 2-3 cm
Ossifies in ~12-18 months
PosteriorTriangle shaped
Smaller
Closes in 8-12 weeks
Fetus Fetal lie
Longitudinal
Transverse
Fetus Fetal lie
Cephalic
Shoulder
Breech
Fetus
Fetal presentation Cephalic
Vertex presentationMost common
Head completely flexed on chest
Suboccipitobregmatic (Smallest diameter)
Occiput in presenting part
Fetus
Fetal presentation CephalicMilitary presentation
Fetal head neither flexed nor extended
Occipitofrontal diameter presents
Top of the head is presenting part
Fetus
Fetal presentation Cephalic
Brow presentationFetal head partially extended
Occipitomental diameter presents
Sinciput is presenting part
Fetus
Fetal presentation Cephalic
Face presentationHead hyperextended
Submentobregmatic diameter presents
Face is presenting part
Fetal presentations
FetusFetal presentation Breech
Sacrum is the landmark
Complete breechKnees and hips are flexed thighs on abdomen (ldquofetal positionrdquo)
Buttocks and feet are presenting parts
FetusFetal presentation Breech
Sacrum is the landmark
Frank breechHips flexed knees extended
Buttocks is presenting part
FetusFetal presentation Breech
Sacrum is the landmark
Footling breechHips and legs extended
Feet are presenting parts (single vs double)
FetusFetal presentation Shoulder
Acromion process of shoulder is presenting part
Station
Station of the head inrelation to ischial spines
1048713In Gynaecoid amp Android pelvis distance between ischial spine to brim is ~5 cm1048713In Anthropoid pelvis distance is ~7 cm1048713In Platypelloid pelvis distance is ~3 cm
Relationship of maternal pelvis and presenting part
Normal uterine action
Normal uterine action
True vs False LaborTrue False
Contractions
Regular uarrfrequency duration intensity
Irregular short duration mild
Pain Starts in back radiates to front
Begins in abdomen
Cervix change
Dilationeffacement No change
Cont change
Does not decrease with rest or warm bath walking makes stronger
Decreases with rest warm bath walking slows
Partogram
Alert line
Acton line
Normal dilatation
Abnormal dilatation
Stages of
Labor
Stages of Labor
1 Birth Passage
1 Birth Passage
1 Birth Passage
1 Birth Passage
1 Birth PassageAsymmetrical pelvises
Abnormality of lower limbAbnormality of pelvic girdleAbnormality of vertebral column
Robertrsquos pelvisOsteomalacic pelvis
Scoliotic pelvisCoxalgic pelvis
Split pelvis Naegelersquos pelvis
1 Birth Passage
Measurement of AP conjugatesbullDiagonal conjugate ~120 cmbullTrue conjugate ~110 cmbullAP outlet ~125 cm
1 Birth Passage
Assess shape of sacrum
2 FetusSutures
Frontal
Sagittal
Coronal
Lambdoidal
Frontal suture
Sagittal suture
Coronal suture
Lambdoidal suture
Note sutures are actually membranous spaces that meet at fontanels
1 Bones 2 parietals 2 frontals 2 temporals occipital2 Sutures sagital frontal lamboidal coronal temporal3 Fontanelles anterior posterior 2 anterior temporals 2 posterior temporals
Foetal skull
Fetal skull
1 Suboccipitobregamatic ~95 cc Vertex2 Suboccipitofrontal ~100 cm Sinciput3 Occipitofrontal~1124 cm persistent OP4 Mentovertical ~138 cm brow5 Submentobregmatic ~95 cm Face6 Submentovertical ~1125 cm incompletelyextended face7 Biparietal diameter ~95 cm
1
2
3
5
6
7
4
Fetus
Fontanelles intersection of sutures allows for molding helps identify position of head
Anterior (bregma)Diamond shaped
Approx 2-3 cm
Ossifies in ~12-18 months
PosteriorTriangle shaped
Smaller
Closes in 8-12 weeks
Fetus Fetal lie
Longitudinal
Transverse
Fetus Fetal lie
Cephalic
Shoulder
Breech
Fetus
Fetal presentation Cephalic
Vertex presentationMost common
Head completely flexed on chest
Suboccipitobregmatic (Smallest diameter)
Occiput in presenting part
Fetus
Fetal presentation CephalicMilitary presentation
Fetal head neither flexed nor extended
Occipitofrontal diameter presents
Top of the head is presenting part
Fetus
Fetal presentation Cephalic
Brow presentationFetal head partially extended
Occipitomental diameter presents
Sinciput is presenting part
Fetus
Fetal presentation Cephalic
Face presentationHead hyperextended
Submentobregmatic diameter presents
Face is presenting part
Fetal presentations
FetusFetal presentation Breech
Sacrum is the landmark
Complete breechKnees and hips are flexed thighs on abdomen (ldquofetal positionrdquo)
Buttocks and feet are presenting parts
FetusFetal presentation Breech
Sacrum is the landmark
Frank breechHips flexed knees extended
Buttocks is presenting part
FetusFetal presentation Breech
Sacrum is the landmark
Footling breechHips and legs extended
Feet are presenting parts (single vs double)
FetusFetal presentation Shoulder
Acromion process of shoulder is presenting part
Station
Station of the head inrelation to ischial spines
1048713In Gynaecoid amp Android pelvis distance between ischial spine to brim is ~5 cm1048713In Anthropoid pelvis distance is ~7 cm1048713In Platypelloid pelvis distance is ~3 cm
Relationship of maternal pelvis and presenting part
Normal uterine action
Normal uterine action
True vs False LaborTrue False
Contractions
Regular uarrfrequency duration intensity
Irregular short duration mild
Pain Starts in back radiates to front
Begins in abdomen
Cervix change
Dilationeffacement No change
Cont change
Does not decrease with rest or warm bath walking makes stronger
Decreases with rest warm bath walking slows
Partogram
Alert line
Acton line
Normal dilatation
Abnormal dilatation
Stages of
Labor
Stages of Labor
1 Birth Passage
1 Birth Passage
1 Birth Passage
1 Birth PassageAsymmetrical pelvises
Abnormality of lower limbAbnormality of pelvic girdleAbnormality of vertebral column
Robertrsquos pelvisOsteomalacic pelvis
Scoliotic pelvisCoxalgic pelvis
Split pelvis Naegelersquos pelvis
1 Birth Passage
Measurement of AP conjugatesbullDiagonal conjugate ~120 cmbullTrue conjugate ~110 cmbullAP outlet ~125 cm
1 Birth Passage
Assess shape of sacrum
2 FetusSutures
Frontal
Sagittal
Coronal
Lambdoidal
Frontal suture
Sagittal suture
Coronal suture
Lambdoidal suture
Note sutures are actually membranous spaces that meet at fontanels
1 Bones 2 parietals 2 frontals 2 temporals occipital2 Sutures sagital frontal lamboidal coronal temporal3 Fontanelles anterior posterior 2 anterior temporals 2 posterior temporals
Foetal skull
Fetal skull
1 Suboccipitobregamatic ~95 cc Vertex2 Suboccipitofrontal ~100 cm Sinciput3 Occipitofrontal~1124 cm persistent OP4 Mentovertical ~138 cm brow5 Submentobregmatic ~95 cm Face6 Submentovertical ~1125 cm incompletelyextended face7 Biparietal diameter ~95 cm
1
2
3
5
6
7
4
Fetus
Fontanelles intersection of sutures allows for molding helps identify position of head
Anterior (bregma)Diamond shaped
Approx 2-3 cm
Ossifies in ~12-18 months
PosteriorTriangle shaped
Smaller
Closes in 8-12 weeks
Fetus Fetal lie
Longitudinal
Transverse
Fetus Fetal lie
Cephalic
Shoulder
Breech
Fetus
Fetal presentation Cephalic
Vertex presentationMost common
Head completely flexed on chest
Suboccipitobregmatic (Smallest diameter)
Occiput in presenting part
Fetus
Fetal presentation CephalicMilitary presentation
Fetal head neither flexed nor extended
Occipitofrontal diameter presents
Top of the head is presenting part
Fetus
Fetal presentation Cephalic
Brow presentationFetal head partially extended
Occipitomental diameter presents
Sinciput is presenting part
Fetus
Fetal presentation Cephalic
Face presentationHead hyperextended
Submentobregmatic diameter presents
Face is presenting part
Fetal presentations
FetusFetal presentation Breech
Sacrum is the landmark
Complete breechKnees and hips are flexed thighs on abdomen (ldquofetal positionrdquo)
Buttocks and feet are presenting parts
FetusFetal presentation Breech
Sacrum is the landmark
Frank breechHips flexed knees extended
Buttocks is presenting part
FetusFetal presentation Breech
Sacrum is the landmark
Footling breechHips and legs extended
Feet are presenting parts (single vs double)
FetusFetal presentation Shoulder
Acromion process of shoulder is presenting part
Station
Station of the head inrelation to ischial spines
1048713In Gynaecoid amp Android pelvis distance between ischial spine to brim is ~5 cm1048713In Anthropoid pelvis distance is ~7 cm1048713In Platypelloid pelvis distance is ~3 cm
Relationship of maternal pelvis and presenting part
Normal uterine action
Normal uterine action
True vs False LaborTrue False
Contractions
Regular uarrfrequency duration intensity
Irregular short duration mild
Pain Starts in back radiates to front
Begins in abdomen
Cervix change
Dilationeffacement No change
Cont change
Does not decrease with rest or warm bath walking makes stronger
Decreases with rest warm bath walking slows
Partogram
Alert line
Acton line
Normal dilatation
Abnormal dilatation
Stages of
Labor
Stages of Labor
1 Birth Passage
1 Birth Passage
1 Birth PassageAsymmetrical pelvises
Abnormality of lower limbAbnormality of pelvic girdleAbnormality of vertebral column
Robertrsquos pelvisOsteomalacic pelvis
Scoliotic pelvisCoxalgic pelvis
Split pelvis Naegelersquos pelvis
1 Birth Passage
Measurement of AP conjugatesbullDiagonal conjugate ~120 cmbullTrue conjugate ~110 cmbullAP outlet ~125 cm
1 Birth Passage
Assess shape of sacrum
2 FetusSutures
Frontal
Sagittal
Coronal
Lambdoidal
Frontal suture
Sagittal suture
Coronal suture
Lambdoidal suture
Note sutures are actually membranous spaces that meet at fontanels
1 Bones 2 parietals 2 frontals 2 temporals occipital2 Sutures sagital frontal lamboidal coronal temporal3 Fontanelles anterior posterior 2 anterior temporals 2 posterior temporals
Foetal skull
Fetal skull
1 Suboccipitobregamatic ~95 cc Vertex2 Suboccipitofrontal ~100 cm Sinciput3 Occipitofrontal~1124 cm persistent OP4 Mentovertical ~138 cm brow5 Submentobregmatic ~95 cm Face6 Submentovertical ~1125 cm incompletelyextended face7 Biparietal diameter ~95 cm
1
2
3
5
6
7
4
Fetus
Fontanelles intersection of sutures allows for molding helps identify position of head
Anterior (bregma)Diamond shaped
Approx 2-3 cm
Ossifies in ~12-18 months
PosteriorTriangle shaped
Smaller
Closes in 8-12 weeks
Fetus Fetal lie
Longitudinal
Transverse
Fetus Fetal lie
Cephalic
Shoulder
Breech
Fetus
Fetal presentation Cephalic
Vertex presentationMost common
Head completely flexed on chest
Suboccipitobregmatic (Smallest diameter)
Occiput in presenting part
Fetus
Fetal presentation CephalicMilitary presentation
Fetal head neither flexed nor extended
Occipitofrontal diameter presents
Top of the head is presenting part
Fetus
Fetal presentation Cephalic
Brow presentationFetal head partially extended
Occipitomental diameter presents
Sinciput is presenting part
Fetus
Fetal presentation Cephalic
Face presentationHead hyperextended
Submentobregmatic diameter presents
Face is presenting part
Fetal presentations
FetusFetal presentation Breech
Sacrum is the landmark
Complete breechKnees and hips are flexed thighs on abdomen (ldquofetal positionrdquo)
Buttocks and feet are presenting parts
FetusFetal presentation Breech
Sacrum is the landmark
Frank breechHips flexed knees extended
Buttocks is presenting part
FetusFetal presentation Breech
Sacrum is the landmark
Footling breechHips and legs extended
Feet are presenting parts (single vs double)
FetusFetal presentation Shoulder
Acromion process of shoulder is presenting part
Station
Station of the head inrelation to ischial spines
1048713In Gynaecoid amp Android pelvis distance between ischial spine to brim is ~5 cm1048713In Anthropoid pelvis distance is ~7 cm1048713In Platypelloid pelvis distance is ~3 cm
Relationship of maternal pelvis and presenting part
Normal uterine action
Normal uterine action
True vs False LaborTrue False
Contractions
Regular uarrfrequency duration intensity
Irregular short duration mild
Pain Starts in back radiates to front
Begins in abdomen
Cervix change
Dilationeffacement No change
Cont change
Does not decrease with rest or warm bath walking makes stronger
Decreases with rest warm bath walking slows
Partogram
Alert line
Acton line
Normal dilatation
Abnormal dilatation
Stages of
Labor
Stages of Labor
1 Birth Passage
1 Birth PassageAsymmetrical pelvises
Abnormality of lower limbAbnormality of pelvic girdleAbnormality of vertebral column
Robertrsquos pelvisOsteomalacic pelvis
Scoliotic pelvisCoxalgic pelvis
Split pelvis Naegelersquos pelvis
1 Birth Passage
Measurement of AP conjugatesbullDiagonal conjugate ~120 cmbullTrue conjugate ~110 cmbullAP outlet ~125 cm
1 Birth Passage
Assess shape of sacrum
2 FetusSutures
Frontal
Sagittal
Coronal
Lambdoidal
Frontal suture
Sagittal suture
Coronal suture
Lambdoidal suture
Note sutures are actually membranous spaces that meet at fontanels
1 Bones 2 parietals 2 frontals 2 temporals occipital2 Sutures sagital frontal lamboidal coronal temporal3 Fontanelles anterior posterior 2 anterior temporals 2 posterior temporals
Foetal skull
Fetal skull
1 Suboccipitobregamatic ~95 cc Vertex2 Suboccipitofrontal ~100 cm Sinciput3 Occipitofrontal~1124 cm persistent OP4 Mentovertical ~138 cm brow5 Submentobregmatic ~95 cm Face6 Submentovertical ~1125 cm incompletelyextended face7 Biparietal diameter ~95 cm
1
2
3
5
6
7
4
Fetus
Fontanelles intersection of sutures allows for molding helps identify position of head
Anterior (bregma)Diamond shaped
Approx 2-3 cm
Ossifies in ~12-18 months
PosteriorTriangle shaped
Smaller
Closes in 8-12 weeks
Fetus Fetal lie
Longitudinal
Transverse
Fetus Fetal lie
Cephalic
Shoulder
Breech
Fetus
Fetal presentation Cephalic
Vertex presentationMost common
Head completely flexed on chest
Suboccipitobregmatic (Smallest diameter)
Occiput in presenting part
Fetus
Fetal presentation CephalicMilitary presentation
Fetal head neither flexed nor extended
Occipitofrontal diameter presents
Top of the head is presenting part
Fetus
Fetal presentation Cephalic
Brow presentationFetal head partially extended
Occipitomental diameter presents
Sinciput is presenting part
Fetus
Fetal presentation Cephalic
Face presentationHead hyperextended
Submentobregmatic diameter presents
Face is presenting part
Fetal presentations
FetusFetal presentation Breech
Sacrum is the landmark
Complete breechKnees and hips are flexed thighs on abdomen (ldquofetal positionrdquo)
Buttocks and feet are presenting parts
FetusFetal presentation Breech
Sacrum is the landmark
Frank breechHips flexed knees extended
Buttocks is presenting part
FetusFetal presentation Breech
Sacrum is the landmark
Footling breechHips and legs extended
Feet are presenting parts (single vs double)
FetusFetal presentation Shoulder
Acromion process of shoulder is presenting part
Station
Station of the head inrelation to ischial spines
1048713In Gynaecoid amp Android pelvis distance between ischial spine to brim is ~5 cm1048713In Anthropoid pelvis distance is ~7 cm1048713In Platypelloid pelvis distance is ~3 cm
Relationship of maternal pelvis and presenting part
Normal uterine action
Normal uterine action
True vs False LaborTrue False
Contractions
Regular uarrfrequency duration intensity
Irregular short duration mild
Pain Starts in back radiates to front
Begins in abdomen
Cervix change
Dilationeffacement No change
Cont change
Does not decrease with rest or warm bath walking makes stronger
Decreases with rest warm bath walking slows
Partogram
Alert line
Acton line
Normal dilatation
Abnormal dilatation
Stages of
Labor
Stages of Labor
1 Birth PassageAsymmetrical pelvises
Abnormality of lower limbAbnormality of pelvic girdleAbnormality of vertebral column
Robertrsquos pelvisOsteomalacic pelvis
Scoliotic pelvisCoxalgic pelvis
Split pelvis Naegelersquos pelvis
1 Birth Passage
Measurement of AP conjugatesbullDiagonal conjugate ~120 cmbullTrue conjugate ~110 cmbullAP outlet ~125 cm
1 Birth Passage
Assess shape of sacrum
2 FetusSutures
Frontal
Sagittal
Coronal
Lambdoidal
Frontal suture
Sagittal suture
Coronal suture
Lambdoidal suture
Note sutures are actually membranous spaces that meet at fontanels
1 Bones 2 parietals 2 frontals 2 temporals occipital2 Sutures sagital frontal lamboidal coronal temporal3 Fontanelles anterior posterior 2 anterior temporals 2 posterior temporals
Foetal skull
Fetal skull
1 Suboccipitobregamatic ~95 cc Vertex2 Suboccipitofrontal ~100 cm Sinciput3 Occipitofrontal~1124 cm persistent OP4 Mentovertical ~138 cm brow5 Submentobregmatic ~95 cm Face6 Submentovertical ~1125 cm incompletelyextended face7 Biparietal diameter ~95 cm
1
2
3
5
6
7
4
Fetus
Fontanelles intersection of sutures allows for molding helps identify position of head
Anterior (bregma)Diamond shaped
Approx 2-3 cm
Ossifies in ~12-18 months
PosteriorTriangle shaped
Smaller
Closes in 8-12 weeks
Fetus Fetal lie
Longitudinal
Transverse
Fetus Fetal lie
Cephalic
Shoulder
Breech
Fetus
Fetal presentation Cephalic
Vertex presentationMost common
Head completely flexed on chest
Suboccipitobregmatic (Smallest diameter)
Occiput in presenting part
Fetus
Fetal presentation CephalicMilitary presentation
Fetal head neither flexed nor extended
Occipitofrontal diameter presents
Top of the head is presenting part
Fetus
Fetal presentation Cephalic
Brow presentationFetal head partially extended
Occipitomental diameter presents
Sinciput is presenting part
Fetus
Fetal presentation Cephalic
Face presentationHead hyperextended
Submentobregmatic diameter presents
Face is presenting part
Fetal presentations
FetusFetal presentation Breech
Sacrum is the landmark
Complete breechKnees and hips are flexed thighs on abdomen (ldquofetal positionrdquo)
Buttocks and feet are presenting parts
FetusFetal presentation Breech
Sacrum is the landmark
Frank breechHips flexed knees extended
Buttocks is presenting part
FetusFetal presentation Breech
Sacrum is the landmark
Footling breechHips and legs extended
Feet are presenting parts (single vs double)
FetusFetal presentation Shoulder
Acromion process of shoulder is presenting part
Station
Station of the head inrelation to ischial spines
1048713In Gynaecoid amp Android pelvis distance between ischial spine to brim is ~5 cm1048713In Anthropoid pelvis distance is ~7 cm1048713In Platypelloid pelvis distance is ~3 cm
Relationship of maternal pelvis and presenting part
Normal uterine action
Normal uterine action
True vs False LaborTrue False
Contractions
Regular uarrfrequency duration intensity
Irregular short duration mild
Pain Starts in back radiates to front
Begins in abdomen
Cervix change
Dilationeffacement No change
Cont change
Does not decrease with rest or warm bath walking makes stronger
Decreases with rest warm bath walking slows
Partogram
Alert line
Acton line
Normal dilatation
Abnormal dilatation
Stages of
Labor
Stages of Labor
1 Birth Passage
Measurement of AP conjugatesbullDiagonal conjugate ~120 cmbullTrue conjugate ~110 cmbullAP outlet ~125 cm
1 Birth Passage
Assess shape of sacrum
2 FetusSutures
Frontal
Sagittal
Coronal
Lambdoidal
Frontal suture
Sagittal suture
Coronal suture
Lambdoidal suture
Note sutures are actually membranous spaces that meet at fontanels
1 Bones 2 parietals 2 frontals 2 temporals occipital2 Sutures sagital frontal lamboidal coronal temporal3 Fontanelles anterior posterior 2 anterior temporals 2 posterior temporals
Foetal skull
Fetal skull
1 Suboccipitobregamatic ~95 cc Vertex2 Suboccipitofrontal ~100 cm Sinciput3 Occipitofrontal~1124 cm persistent OP4 Mentovertical ~138 cm brow5 Submentobregmatic ~95 cm Face6 Submentovertical ~1125 cm incompletelyextended face7 Biparietal diameter ~95 cm
1
2
3
5
6
7
4
Fetus
Fontanelles intersection of sutures allows for molding helps identify position of head
Anterior (bregma)Diamond shaped
Approx 2-3 cm
Ossifies in ~12-18 months
PosteriorTriangle shaped
Smaller
Closes in 8-12 weeks
Fetus Fetal lie
Longitudinal
Transverse
Fetus Fetal lie
Cephalic
Shoulder
Breech
Fetus
Fetal presentation Cephalic
Vertex presentationMost common
Head completely flexed on chest
Suboccipitobregmatic (Smallest diameter)
Occiput in presenting part
Fetus
Fetal presentation CephalicMilitary presentation
Fetal head neither flexed nor extended
Occipitofrontal diameter presents
Top of the head is presenting part
Fetus
Fetal presentation Cephalic
Brow presentationFetal head partially extended
Occipitomental diameter presents
Sinciput is presenting part
Fetus
Fetal presentation Cephalic
Face presentationHead hyperextended
Submentobregmatic diameter presents
Face is presenting part
Fetal presentations
FetusFetal presentation Breech
Sacrum is the landmark
Complete breechKnees and hips are flexed thighs on abdomen (ldquofetal positionrdquo)
Buttocks and feet are presenting parts
FetusFetal presentation Breech
Sacrum is the landmark
Frank breechHips flexed knees extended
Buttocks is presenting part
FetusFetal presentation Breech
Sacrum is the landmark
Footling breechHips and legs extended
Feet are presenting parts (single vs double)
FetusFetal presentation Shoulder
Acromion process of shoulder is presenting part
Station
Station of the head inrelation to ischial spines
1048713In Gynaecoid amp Android pelvis distance between ischial spine to brim is ~5 cm1048713In Anthropoid pelvis distance is ~7 cm1048713In Platypelloid pelvis distance is ~3 cm
Relationship of maternal pelvis and presenting part
Normal uterine action
Normal uterine action
True vs False LaborTrue False
Contractions
Regular uarrfrequency duration intensity
Irregular short duration mild
Pain Starts in back radiates to front
Begins in abdomen
Cervix change
Dilationeffacement No change
Cont change
Does not decrease with rest or warm bath walking makes stronger
Decreases with rest warm bath walking slows
Partogram
Alert line
Acton line
Normal dilatation
Abnormal dilatation
Stages of
Labor
Stages of Labor
1 Birth Passage
Assess shape of sacrum
2 FetusSutures
Frontal
Sagittal
Coronal
Lambdoidal
Frontal suture
Sagittal suture
Coronal suture
Lambdoidal suture
Note sutures are actually membranous spaces that meet at fontanels
1 Bones 2 parietals 2 frontals 2 temporals occipital2 Sutures sagital frontal lamboidal coronal temporal3 Fontanelles anterior posterior 2 anterior temporals 2 posterior temporals
Foetal skull
Fetal skull
1 Suboccipitobregamatic ~95 cc Vertex2 Suboccipitofrontal ~100 cm Sinciput3 Occipitofrontal~1124 cm persistent OP4 Mentovertical ~138 cm brow5 Submentobregmatic ~95 cm Face6 Submentovertical ~1125 cm incompletelyextended face7 Biparietal diameter ~95 cm
1
2
3
5
6
7
4
Fetus
Fontanelles intersection of sutures allows for molding helps identify position of head
Anterior (bregma)Diamond shaped
Approx 2-3 cm
Ossifies in ~12-18 months
PosteriorTriangle shaped
Smaller
Closes in 8-12 weeks
Fetus Fetal lie
Longitudinal
Transverse
Fetus Fetal lie
Cephalic
Shoulder
Breech
Fetus
Fetal presentation Cephalic
Vertex presentationMost common
Head completely flexed on chest
Suboccipitobregmatic (Smallest diameter)
Occiput in presenting part
Fetus
Fetal presentation CephalicMilitary presentation
Fetal head neither flexed nor extended
Occipitofrontal diameter presents
Top of the head is presenting part
Fetus
Fetal presentation Cephalic
Brow presentationFetal head partially extended
Occipitomental diameter presents
Sinciput is presenting part
Fetus
Fetal presentation Cephalic
Face presentationHead hyperextended
Submentobregmatic diameter presents
Face is presenting part
Fetal presentations
FetusFetal presentation Breech
Sacrum is the landmark
Complete breechKnees and hips are flexed thighs on abdomen (ldquofetal positionrdquo)
Buttocks and feet are presenting parts
FetusFetal presentation Breech
Sacrum is the landmark
Frank breechHips flexed knees extended
Buttocks is presenting part
FetusFetal presentation Breech
Sacrum is the landmark
Footling breechHips and legs extended
Feet are presenting parts (single vs double)
FetusFetal presentation Shoulder
Acromion process of shoulder is presenting part
Station
Station of the head inrelation to ischial spines
1048713In Gynaecoid amp Android pelvis distance between ischial spine to brim is ~5 cm1048713In Anthropoid pelvis distance is ~7 cm1048713In Platypelloid pelvis distance is ~3 cm
Relationship of maternal pelvis and presenting part
Normal uterine action
Normal uterine action
True vs False LaborTrue False
Contractions
Regular uarrfrequency duration intensity
Irregular short duration mild
Pain Starts in back radiates to front
Begins in abdomen
Cervix change
Dilationeffacement No change
Cont change
Does not decrease with rest or warm bath walking makes stronger
Decreases with rest warm bath walking slows
Partogram
Alert line
Acton line
Normal dilatation
Abnormal dilatation
Stages of
Labor
Stages of Labor
2 FetusSutures
Frontal
Sagittal
Coronal
Lambdoidal
Frontal suture
Sagittal suture
Coronal suture
Lambdoidal suture
Note sutures are actually membranous spaces that meet at fontanels
1 Bones 2 parietals 2 frontals 2 temporals occipital2 Sutures sagital frontal lamboidal coronal temporal3 Fontanelles anterior posterior 2 anterior temporals 2 posterior temporals
Foetal skull
Fetal skull
1 Suboccipitobregamatic ~95 cc Vertex2 Suboccipitofrontal ~100 cm Sinciput3 Occipitofrontal~1124 cm persistent OP4 Mentovertical ~138 cm brow5 Submentobregmatic ~95 cm Face6 Submentovertical ~1125 cm incompletelyextended face7 Biparietal diameter ~95 cm
1
2
3
5
6
7
4
Fetus
Fontanelles intersection of sutures allows for molding helps identify position of head
Anterior (bregma)Diamond shaped
Approx 2-3 cm
Ossifies in ~12-18 months
PosteriorTriangle shaped
Smaller
Closes in 8-12 weeks
Fetus Fetal lie
Longitudinal
Transverse
Fetus Fetal lie
Cephalic
Shoulder
Breech
Fetus
Fetal presentation Cephalic
Vertex presentationMost common
Head completely flexed on chest
Suboccipitobregmatic (Smallest diameter)
Occiput in presenting part
Fetus
Fetal presentation CephalicMilitary presentation
Fetal head neither flexed nor extended
Occipitofrontal diameter presents
Top of the head is presenting part
Fetus
Fetal presentation Cephalic
Brow presentationFetal head partially extended
Occipitomental diameter presents
Sinciput is presenting part
Fetus
Fetal presentation Cephalic
Face presentationHead hyperextended
Submentobregmatic diameter presents
Face is presenting part
Fetal presentations
FetusFetal presentation Breech
Sacrum is the landmark
Complete breechKnees and hips are flexed thighs on abdomen (ldquofetal positionrdquo)
Buttocks and feet are presenting parts
FetusFetal presentation Breech
Sacrum is the landmark
Frank breechHips flexed knees extended
Buttocks is presenting part
FetusFetal presentation Breech
Sacrum is the landmark
Footling breechHips and legs extended
Feet are presenting parts (single vs double)
FetusFetal presentation Shoulder
Acromion process of shoulder is presenting part
Station
Station of the head inrelation to ischial spines
1048713In Gynaecoid amp Android pelvis distance between ischial spine to brim is ~5 cm1048713In Anthropoid pelvis distance is ~7 cm1048713In Platypelloid pelvis distance is ~3 cm
Relationship of maternal pelvis and presenting part
Normal uterine action
Normal uterine action
True vs False LaborTrue False
Contractions
Regular uarrfrequency duration intensity
Irregular short duration mild
Pain Starts in back radiates to front
Begins in abdomen
Cervix change
Dilationeffacement No change
Cont change
Does not decrease with rest or warm bath walking makes stronger
Decreases with rest warm bath walking slows
Partogram
Alert line
Acton line
Normal dilatation
Abnormal dilatation
Stages of
Labor
Stages of Labor
1 Bones 2 parietals 2 frontals 2 temporals occipital2 Sutures sagital frontal lamboidal coronal temporal3 Fontanelles anterior posterior 2 anterior temporals 2 posterior temporals
Foetal skull
Fetal skull
1 Suboccipitobregamatic ~95 cc Vertex2 Suboccipitofrontal ~100 cm Sinciput3 Occipitofrontal~1124 cm persistent OP4 Mentovertical ~138 cm brow5 Submentobregmatic ~95 cm Face6 Submentovertical ~1125 cm incompletelyextended face7 Biparietal diameter ~95 cm
1
2
3
5
6
7
4
Fetus
Fontanelles intersection of sutures allows for molding helps identify position of head
Anterior (bregma)Diamond shaped
Approx 2-3 cm
Ossifies in ~12-18 months
PosteriorTriangle shaped
Smaller
Closes in 8-12 weeks
Fetus Fetal lie
Longitudinal
Transverse
Fetus Fetal lie
Cephalic
Shoulder
Breech
Fetus
Fetal presentation Cephalic
Vertex presentationMost common
Head completely flexed on chest
Suboccipitobregmatic (Smallest diameter)
Occiput in presenting part
Fetus
Fetal presentation CephalicMilitary presentation
Fetal head neither flexed nor extended
Occipitofrontal diameter presents
Top of the head is presenting part
Fetus
Fetal presentation Cephalic
Brow presentationFetal head partially extended
Occipitomental diameter presents
Sinciput is presenting part
Fetus
Fetal presentation Cephalic
Face presentationHead hyperextended
Submentobregmatic diameter presents
Face is presenting part
Fetal presentations
FetusFetal presentation Breech
Sacrum is the landmark
Complete breechKnees and hips are flexed thighs on abdomen (ldquofetal positionrdquo)
Buttocks and feet are presenting parts
FetusFetal presentation Breech
Sacrum is the landmark
Frank breechHips flexed knees extended
Buttocks is presenting part
FetusFetal presentation Breech
Sacrum is the landmark
Footling breechHips and legs extended
Feet are presenting parts (single vs double)
FetusFetal presentation Shoulder
Acromion process of shoulder is presenting part
Station
Station of the head inrelation to ischial spines
1048713In Gynaecoid amp Android pelvis distance between ischial spine to brim is ~5 cm1048713In Anthropoid pelvis distance is ~7 cm1048713In Platypelloid pelvis distance is ~3 cm
Relationship of maternal pelvis and presenting part
Normal uterine action
Normal uterine action
True vs False LaborTrue False
Contractions
Regular uarrfrequency duration intensity
Irregular short duration mild
Pain Starts in back radiates to front
Begins in abdomen
Cervix change
Dilationeffacement No change
Cont change
Does not decrease with rest or warm bath walking makes stronger
Decreases with rest warm bath walking slows
Partogram
Alert line
Acton line
Normal dilatation
Abnormal dilatation
Stages of
Labor
Stages of Labor
Fetal skull
1 Suboccipitobregamatic ~95 cc Vertex2 Suboccipitofrontal ~100 cm Sinciput3 Occipitofrontal~1124 cm persistent OP4 Mentovertical ~138 cm brow5 Submentobregmatic ~95 cm Face6 Submentovertical ~1125 cm incompletelyextended face7 Biparietal diameter ~95 cm
1
2
3
5
6
7
4
Fetus
Fontanelles intersection of sutures allows for molding helps identify position of head
Anterior (bregma)Diamond shaped
Approx 2-3 cm
Ossifies in ~12-18 months
PosteriorTriangle shaped
Smaller
Closes in 8-12 weeks
Fetus Fetal lie
Longitudinal
Transverse
Fetus Fetal lie
Cephalic
Shoulder
Breech
Fetus
Fetal presentation Cephalic
Vertex presentationMost common
Head completely flexed on chest
Suboccipitobregmatic (Smallest diameter)
Occiput in presenting part
Fetus
Fetal presentation CephalicMilitary presentation
Fetal head neither flexed nor extended
Occipitofrontal diameter presents
Top of the head is presenting part
Fetus
Fetal presentation Cephalic
Brow presentationFetal head partially extended
Occipitomental diameter presents
Sinciput is presenting part
Fetus
Fetal presentation Cephalic
Face presentationHead hyperextended
Submentobregmatic diameter presents
Face is presenting part
Fetal presentations
FetusFetal presentation Breech
Sacrum is the landmark
Complete breechKnees and hips are flexed thighs on abdomen (ldquofetal positionrdquo)
Buttocks and feet are presenting parts
FetusFetal presentation Breech
Sacrum is the landmark
Frank breechHips flexed knees extended
Buttocks is presenting part
FetusFetal presentation Breech
Sacrum is the landmark
Footling breechHips and legs extended
Feet are presenting parts (single vs double)
FetusFetal presentation Shoulder
Acromion process of shoulder is presenting part
Station
Station of the head inrelation to ischial spines
1048713In Gynaecoid amp Android pelvis distance between ischial spine to brim is ~5 cm1048713In Anthropoid pelvis distance is ~7 cm1048713In Platypelloid pelvis distance is ~3 cm
Relationship of maternal pelvis and presenting part
Normal uterine action
Normal uterine action
True vs False LaborTrue False
Contractions
Regular uarrfrequency duration intensity
Irregular short duration mild
Pain Starts in back radiates to front
Begins in abdomen
Cervix change
Dilationeffacement No change
Cont change
Does not decrease with rest or warm bath walking makes stronger
Decreases with rest warm bath walking slows
Partogram
Alert line
Acton line
Normal dilatation
Abnormal dilatation
Stages of
Labor
Stages of Labor
Fetus
Fontanelles intersection of sutures allows for molding helps identify position of head
Anterior (bregma)Diamond shaped
Approx 2-3 cm
Ossifies in ~12-18 months
PosteriorTriangle shaped
Smaller
Closes in 8-12 weeks
Fetus Fetal lie
Longitudinal
Transverse
Fetus Fetal lie
Cephalic
Shoulder
Breech
Fetus
Fetal presentation Cephalic
Vertex presentationMost common
Head completely flexed on chest
Suboccipitobregmatic (Smallest diameter)
Occiput in presenting part
Fetus
Fetal presentation CephalicMilitary presentation
Fetal head neither flexed nor extended
Occipitofrontal diameter presents
Top of the head is presenting part
Fetus
Fetal presentation Cephalic
Brow presentationFetal head partially extended
Occipitomental diameter presents
Sinciput is presenting part
Fetus
Fetal presentation Cephalic
Face presentationHead hyperextended
Submentobregmatic diameter presents
Face is presenting part
Fetal presentations
FetusFetal presentation Breech
Sacrum is the landmark
Complete breechKnees and hips are flexed thighs on abdomen (ldquofetal positionrdquo)
Buttocks and feet are presenting parts
FetusFetal presentation Breech
Sacrum is the landmark
Frank breechHips flexed knees extended
Buttocks is presenting part
FetusFetal presentation Breech
Sacrum is the landmark
Footling breechHips and legs extended
Feet are presenting parts (single vs double)
FetusFetal presentation Shoulder
Acromion process of shoulder is presenting part
Station
Station of the head inrelation to ischial spines
1048713In Gynaecoid amp Android pelvis distance between ischial spine to brim is ~5 cm1048713In Anthropoid pelvis distance is ~7 cm1048713In Platypelloid pelvis distance is ~3 cm
Relationship of maternal pelvis and presenting part
Normal uterine action
Normal uterine action
True vs False LaborTrue False
Contractions
Regular uarrfrequency duration intensity
Irregular short duration mild
Pain Starts in back radiates to front
Begins in abdomen
Cervix change
Dilationeffacement No change
Cont change
Does not decrease with rest or warm bath walking makes stronger
Decreases with rest warm bath walking slows
Partogram
Alert line
Acton line
Normal dilatation
Abnormal dilatation
Stages of
Labor
Stages of Labor
Fetus Fetal lie
Longitudinal
Transverse
Fetus Fetal lie
Cephalic
Shoulder
Breech
Fetus
Fetal presentation Cephalic
Vertex presentationMost common
Head completely flexed on chest
Suboccipitobregmatic (Smallest diameter)
Occiput in presenting part
Fetus
Fetal presentation CephalicMilitary presentation
Fetal head neither flexed nor extended
Occipitofrontal diameter presents
Top of the head is presenting part
Fetus
Fetal presentation Cephalic
Brow presentationFetal head partially extended
Occipitomental diameter presents
Sinciput is presenting part
Fetus
Fetal presentation Cephalic
Face presentationHead hyperextended
Submentobregmatic diameter presents
Face is presenting part
Fetal presentations
FetusFetal presentation Breech
Sacrum is the landmark
Complete breechKnees and hips are flexed thighs on abdomen (ldquofetal positionrdquo)
Buttocks and feet are presenting parts
FetusFetal presentation Breech
Sacrum is the landmark
Frank breechHips flexed knees extended
Buttocks is presenting part
FetusFetal presentation Breech
Sacrum is the landmark
Footling breechHips and legs extended
Feet are presenting parts (single vs double)
FetusFetal presentation Shoulder
Acromion process of shoulder is presenting part
Station
Station of the head inrelation to ischial spines
1048713In Gynaecoid amp Android pelvis distance between ischial spine to brim is ~5 cm1048713In Anthropoid pelvis distance is ~7 cm1048713In Platypelloid pelvis distance is ~3 cm
Relationship of maternal pelvis and presenting part
Normal uterine action
Normal uterine action
True vs False LaborTrue False
Contractions
Regular uarrfrequency duration intensity
Irregular short duration mild
Pain Starts in back radiates to front
Begins in abdomen
Cervix change
Dilationeffacement No change
Cont change
Does not decrease with rest or warm bath walking makes stronger
Decreases with rest warm bath walking slows
Partogram
Alert line
Acton line
Normal dilatation
Abnormal dilatation
Stages of
Labor
Stages of Labor
Fetus Fetal lie
Cephalic
Shoulder
Breech
Fetus
Fetal presentation Cephalic
Vertex presentationMost common
Head completely flexed on chest
Suboccipitobregmatic (Smallest diameter)
Occiput in presenting part
Fetus
Fetal presentation CephalicMilitary presentation
Fetal head neither flexed nor extended
Occipitofrontal diameter presents
Top of the head is presenting part
Fetus
Fetal presentation Cephalic
Brow presentationFetal head partially extended
Occipitomental diameter presents
Sinciput is presenting part
Fetus
Fetal presentation Cephalic
Face presentationHead hyperextended
Submentobregmatic diameter presents
Face is presenting part
Fetal presentations
FetusFetal presentation Breech
Sacrum is the landmark
Complete breechKnees and hips are flexed thighs on abdomen (ldquofetal positionrdquo)
Buttocks and feet are presenting parts
FetusFetal presentation Breech
Sacrum is the landmark
Frank breechHips flexed knees extended
Buttocks is presenting part
FetusFetal presentation Breech
Sacrum is the landmark
Footling breechHips and legs extended
Feet are presenting parts (single vs double)
FetusFetal presentation Shoulder
Acromion process of shoulder is presenting part
Station
Station of the head inrelation to ischial spines
1048713In Gynaecoid amp Android pelvis distance between ischial spine to brim is ~5 cm1048713In Anthropoid pelvis distance is ~7 cm1048713In Platypelloid pelvis distance is ~3 cm
Relationship of maternal pelvis and presenting part
Normal uterine action
Normal uterine action
True vs False LaborTrue False
Contractions
Regular uarrfrequency duration intensity
Irregular short duration mild
Pain Starts in back radiates to front
Begins in abdomen
Cervix change
Dilationeffacement No change
Cont change
Does not decrease with rest or warm bath walking makes stronger
Decreases with rest warm bath walking slows
Partogram
Alert line
Acton line
Normal dilatation
Abnormal dilatation
Stages of
Labor
Stages of Labor
Fetus
Fetal presentation Cephalic
Vertex presentationMost common
Head completely flexed on chest
Suboccipitobregmatic (Smallest diameter)
Occiput in presenting part
Fetus
Fetal presentation CephalicMilitary presentation
Fetal head neither flexed nor extended
Occipitofrontal diameter presents
Top of the head is presenting part
Fetus
Fetal presentation Cephalic
Brow presentationFetal head partially extended
Occipitomental diameter presents
Sinciput is presenting part
Fetus
Fetal presentation Cephalic
Face presentationHead hyperextended
Submentobregmatic diameter presents
Face is presenting part
Fetal presentations
FetusFetal presentation Breech
Sacrum is the landmark
Complete breechKnees and hips are flexed thighs on abdomen (ldquofetal positionrdquo)
Buttocks and feet are presenting parts
FetusFetal presentation Breech
Sacrum is the landmark
Frank breechHips flexed knees extended
Buttocks is presenting part
FetusFetal presentation Breech
Sacrum is the landmark
Footling breechHips and legs extended
Feet are presenting parts (single vs double)
FetusFetal presentation Shoulder
Acromion process of shoulder is presenting part
Station
Station of the head inrelation to ischial spines
1048713In Gynaecoid amp Android pelvis distance between ischial spine to brim is ~5 cm1048713In Anthropoid pelvis distance is ~7 cm1048713In Platypelloid pelvis distance is ~3 cm
Relationship of maternal pelvis and presenting part
Normal uterine action
Normal uterine action
True vs False LaborTrue False
Contractions
Regular uarrfrequency duration intensity
Irregular short duration mild
Pain Starts in back radiates to front
Begins in abdomen
Cervix change
Dilationeffacement No change
Cont change
Does not decrease with rest or warm bath walking makes stronger
Decreases with rest warm bath walking slows
Partogram
Alert line
Acton line
Normal dilatation
Abnormal dilatation
Stages of
Labor
Stages of Labor
Fetus
Fetal presentation CephalicMilitary presentation
Fetal head neither flexed nor extended
Occipitofrontal diameter presents
Top of the head is presenting part
Fetus
Fetal presentation Cephalic
Brow presentationFetal head partially extended
Occipitomental diameter presents
Sinciput is presenting part
Fetus
Fetal presentation Cephalic
Face presentationHead hyperextended
Submentobregmatic diameter presents
Face is presenting part
Fetal presentations
FetusFetal presentation Breech
Sacrum is the landmark
Complete breechKnees and hips are flexed thighs on abdomen (ldquofetal positionrdquo)
Buttocks and feet are presenting parts
FetusFetal presentation Breech
Sacrum is the landmark
Frank breechHips flexed knees extended
Buttocks is presenting part
FetusFetal presentation Breech
Sacrum is the landmark
Footling breechHips and legs extended
Feet are presenting parts (single vs double)
FetusFetal presentation Shoulder
Acromion process of shoulder is presenting part
Station
Station of the head inrelation to ischial spines
1048713In Gynaecoid amp Android pelvis distance between ischial spine to brim is ~5 cm1048713In Anthropoid pelvis distance is ~7 cm1048713In Platypelloid pelvis distance is ~3 cm
Relationship of maternal pelvis and presenting part
Normal uterine action
Normal uterine action
True vs False LaborTrue False
Contractions
Regular uarrfrequency duration intensity
Irregular short duration mild
Pain Starts in back radiates to front
Begins in abdomen
Cervix change
Dilationeffacement No change
Cont change
Does not decrease with rest or warm bath walking makes stronger
Decreases with rest warm bath walking slows
Partogram
Alert line
Acton line
Normal dilatation
Abnormal dilatation
Stages of
Labor
Stages of Labor
Fetus
Fetal presentation Cephalic
Brow presentationFetal head partially extended
Occipitomental diameter presents
Sinciput is presenting part
Fetus
Fetal presentation Cephalic
Face presentationHead hyperextended
Submentobregmatic diameter presents
Face is presenting part
Fetal presentations
FetusFetal presentation Breech
Sacrum is the landmark
Complete breechKnees and hips are flexed thighs on abdomen (ldquofetal positionrdquo)
Buttocks and feet are presenting parts
FetusFetal presentation Breech
Sacrum is the landmark
Frank breechHips flexed knees extended
Buttocks is presenting part
FetusFetal presentation Breech
Sacrum is the landmark
Footling breechHips and legs extended
Feet are presenting parts (single vs double)
FetusFetal presentation Shoulder
Acromion process of shoulder is presenting part
Station
Station of the head inrelation to ischial spines
1048713In Gynaecoid amp Android pelvis distance between ischial spine to brim is ~5 cm1048713In Anthropoid pelvis distance is ~7 cm1048713In Platypelloid pelvis distance is ~3 cm
Relationship of maternal pelvis and presenting part
Normal uterine action
Normal uterine action
True vs False LaborTrue False
Contractions
Regular uarrfrequency duration intensity
Irregular short duration mild
Pain Starts in back radiates to front
Begins in abdomen
Cervix change
Dilationeffacement No change
Cont change
Does not decrease with rest or warm bath walking makes stronger
Decreases with rest warm bath walking slows
Partogram
Alert line
Acton line
Normal dilatation
Abnormal dilatation
Stages of
Labor
Stages of Labor
Fetus
Fetal presentation Cephalic
Face presentationHead hyperextended
Submentobregmatic diameter presents
Face is presenting part
Fetal presentations
FetusFetal presentation Breech
Sacrum is the landmark
Complete breechKnees and hips are flexed thighs on abdomen (ldquofetal positionrdquo)
Buttocks and feet are presenting parts
FetusFetal presentation Breech
Sacrum is the landmark
Frank breechHips flexed knees extended
Buttocks is presenting part
FetusFetal presentation Breech
Sacrum is the landmark
Footling breechHips and legs extended
Feet are presenting parts (single vs double)
FetusFetal presentation Shoulder
Acromion process of shoulder is presenting part
Station
Station of the head inrelation to ischial spines
1048713In Gynaecoid amp Android pelvis distance between ischial spine to brim is ~5 cm1048713In Anthropoid pelvis distance is ~7 cm1048713In Platypelloid pelvis distance is ~3 cm
Relationship of maternal pelvis and presenting part
Normal uterine action
Normal uterine action
True vs False LaborTrue False
Contractions
Regular uarrfrequency duration intensity
Irregular short duration mild
Pain Starts in back radiates to front
Begins in abdomen
Cervix change
Dilationeffacement No change
Cont change
Does not decrease with rest or warm bath walking makes stronger
Decreases with rest warm bath walking slows
Partogram
Alert line
Acton line
Normal dilatation
Abnormal dilatation
Stages of
Labor
Stages of Labor
Fetal presentations
FetusFetal presentation Breech
Sacrum is the landmark
Complete breechKnees and hips are flexed thighs on abdomen (ldquofetal positionrdquo)
Buttocks and feet are presenting parts
FetusFetal presentation Breech
Sacrum is the landmark
Frank breechHips flexed knees extended
Buttocks is presenting part
FetusFetal presentation Breech
Sacrum is the landmark
Footling breechHips and legs extended
Feet are presenting parts (single vs double)
FetusFetal presentation Shoulder
Acromion process of shoulder is presenting part
Station
Station of the head inrelation to ischial spines
1048713In Gynaecoid amp Android pelvis distance between ischial spine to brim is ~5 cm1048713In Anthropoid pelvis distance is ~7 cm1048713In Platypelloid pelvis distance is ~3 cm
Relationship of maternal pelvis and presenting part
Normal uterine action
Normal uterine action
True vs False LaborTrue False
Contractions
Regular uarrfrequency duration intensity
Irregular short duration mild
Pain Starts in back radiates to front
Begins in abdomen
Cervix change
Dilationeffacement No change
Cont change
Does not decrease with rest or warm bath walking makes stronger
Decreases with rest warm bath walking slows
Partogram
Alert line
Acton line
Normal dilatation
Abnormal dilatation
Stages of
Labor
Stages of Labor
FetusFetal presentation Breech
Sacrum is the landmark
Complete breechKnees and hips are flexed thighs on abdomen (ldquofetal positionrdquo)
Buttocks and feet are presenting parts
FetusFetal presentation Breech
Sacrum is the landmark
Frank breechHips flexed knees extended
Buttocks is presenting part
FetusFetal presentation Breech
Sacrum is the landmark
Footling breechHips and legs extended
Feet are presenting parts (single vs double)
FetusFetal presentation Shoulder
Acromion process of shoulder is presenting part
Station
Station of the head inrelation to ischial spines
1048713In Gynaecoid amp Android pelvis distance between ischial spine to brim is ~5 cm1048713In Anthropoid pelvis distance is ~7 cm1048713In Platypelloid pelvis distance is ~3 cm
Relationship of maternal pelvis and presenting part
Normal uterine action
Normal uterine action
True vs False LaborTrue False
Contractions
Regular uarrfrequency duration intensity
Irregular short duration mild
Pain Starts in back radiates to front
Begins in abdomen
Cervix change
Dilationeffacement No change
Cont change
Does not decrease with rest or warm bath walking makes stronger
Decreases with rest warm bath walking slows
Partogram
Alert line
Acton line
Normal dilatation
Abnormal dilatation
Stages of
Labor
Stages of Labor
FetusFetal presentation Breech
Sacrum is the landmark
Frank breechHips flexed knees extended
Buttocks is presenting part
FetusFetal presentation Breech
Sacrum is the landmark
Footling breechHips and legs extended
Feet are presenting parts (single vs double)
FetusFetal presentation Shoulder
Acromion process of shoulder is presenting part
Station
Station of the head inrelation to ischial spines
1048713In Gynaecoid amp Android pelvis distance between ischial spine to brim is ~5 cm1048713In Anthropoid pelvis distance is ~7 cm1048713In Platypelloid pelvis distance is ~3 cm
Relationship of maternal pelvis and presenting part
Normal uterine action
Normal uterine action
True vs False LaborTrue False
Contractions
Regular uarrfrequency duration intensity
Irregular short duration mild
Pain Starts in back radiates to front
Begins in abdomen
Cervix change
Dilationeffacement No change
Cont change
Does not decrease with rest or warm bath walking makes stronger
Decreases with rest warm bath walking slows
Partogram
Alert line
Acton line
Normal dilatation
Abnormal dilatation
Stages of
Labor
Stages of Labor
FetusFetal presentation Breech
Sacrum is the landmark
Footling breechHips and legs extended
Feet are presenting parts (single vs double)
FetusFetal presentation Shoulder
Acromion process of shoulder is presenting part
Station
Station of the head inrelation to ischial spines
1048713In Gynaecoid amp Android pelvis distance between ischial spine to brim is ~5 cm1048713In Anthropoid pelvis distance is ~7 cm1048713In Platypelloid pelvis distance is ~3 cm
Relationship of maternal pelvis and presenting part
Normal uterine action
Normal uterine action
True vs False LaborTrue False
Contractions
Regular uarrfrequency duration intensity
Irregular short duration mild
Pain Starts in back radiates to front
Begins in abdomen
Cervix change
Dilationeffacement No change
Cont change
Does not decrease with rest or warm bath walking makes stronger
Decreases with rest warm bath walking slows
Partogram
Alert line
Acton line
Normal dilatation
Abnormal dilatation
Stages of
Labor
Stages of Labor
FetusFetal presentation Shoulder
Acromion process of shoulder is presenting part
Station
Station of the head inrelation to ischial spines
1048713In Gynaecoid amp Android pelvis distance between ischial spine to brim is ~5 cm1048713In Anthropoid pelvis distance is ~7 cm1048713In Platypelloid pelvis distance is ~3 cm
Relationship of maternal pelvis and presenting part
Normal uterine action
Normal uterine action
True vs False LaborTrue False
Contractions
Regular uarrfrequency duration intensity
Irregular short duration mild
Pain Starts in back radiates to front
Begins in abdomen
Cervix change
Dilationeffacement No change
Cont change
Does not decrease with rest or warm bath walking makes stronger
Decreases with rest warm bath walking slows
Partogram
Alert line
Acton line
Normal dilatation
Abnormal dilatation
Stages of
Labor
Stages of Labor
Station
Station of the head inrelation to ischial spines
1048713In Gynaecoid amp Android pelvis distance between ischial spine to brim is ~5 cm1048713In Anthropoid pelvis distance is ~7 cm1048713In Platypelloid pelvis distance is ~3 cm
Relationship of maternal pelvis and presenting part
Normal uterine action
Normal uterine action
True vs False LaborTrue False
Contractions
Regular uarrfrequency duration intensity
Irregular short duration mild
Pain Starts in back radiates to front
Begins in abdomen
Cervix change
Dilationeffacement No change
Cont change
Does not decrease with rest or warm bath walking makes stronger
Decreases with rest warm bath walking slows
Partogram
Alert line
Acton line
Normal dilatation
Abnormal dilatation
Stages of
Labor
Stages of Labor
Relationship of maternal pelvis and presenting part
Normal uterine action
Normal uterine action
True vs False LaborTrue False
Contractions
Regular uarrfrequency duration intensity
Irregular short duration mild
Pain Starts in back radiates to front
Begins in abdomen
Cervix change
Dilationeffacement No change
Cont change
Does not decrease with rest or warm bath walking makes stronger
Decreases with rest warm bath walking slows
Partogram
Alert line
Acton line
Normal dilatation
Abnormal dilatation
Stages of
Labor
Stages of Labor
Normal uterine action
Normal uterine action
True vs False LaborTrue False
Contractions
Regular uarrfrequency duration intensity
Irregular short duration mild
Pain Starts in back radiates to front
Begins in abdomen
Cervix change
Dilationeffacement No change
Cont change
Does not decrease with rest or warm bath walking makes stronger
Decreases with rest warm bath walking slows
Partogram
Alert line
Acton line
Normal dilatation
Abnormal dilatation
Stages of
Labor
Stages of Labor
Normal uterine action
True vs False LaborTrue False
Contractions
Regular uarrfrequency duration intensity
Irregular short duration mild
Pain Starts in back radiates to front
Begins in abdomen
Cervix change
Dilationeffacement No change
Cont change
Does not decrease with rest or warm bath walking makes stronger
Decreases with rest warm bath walking slows
Partogram
Alert line
Acton line
Normal dilatation
Abnormal dilatation
Stages of
Labor
Stages of Labor
True vs False LaborTrue False
Contractions
Regular uarrfrequency duration intensity
Irregular short duration mild
Pain Starts in back radiates to front
Begins in abdomen
Cervix change
Dilationeffacement No change
Cont change
Does not decrease with rest or warm bath walking makes stronger
Decreases with rest warm bath walking slows
Partogram
Alert line
Acton line
Normal dilatation
Abnormal dilatation
Stages of
Labor
Stages of Labor
Partogram
Alert line
Acton line
Normal dilatation
Abnormal dilatation
Stages of
Labor
Stages of Labor
Stages of
Labor
Stages of Labor
Stages of Labor