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Relationship of presenting part to maternal pelvis based on presentation. The fetus enters the pelvis in the occipito-transverse plane (left or right), descent, and flexion and then rotates 90 degrees to the occipitoanterior (most commonly). Cephalic presentation. Vertex presentation with longitudinal lie: [1]
In obstetrics, position is the orientation of the fetus in the womb, identified by the location of the presenting part of the fetus relative to the pelvis of the mother. Conventionally, it is the position assumed by the fetus before the process of birth, as the fetus assumes various positions and postures during the course of childbirth .
In obstetrics, Leopold maneuvers are a common and systematic way to determine the position of a fetus inside the woman's uterus. They are named after the gynecologist Christian Gerhard Leopold. They are also used to estimate term fetal weight. [1] The maneuvers consist of four distinct actions, each helping to determine the position of the fetus.
In obstetrics, a cephalic presentation or head presentation or head-first presentation is a situation at childbirth where the fetus is in a longitudinal lie and the head enters the pelvis first; the most common form of cephalic presentation is the vertex presentation, where the occiput is the leading part (the part that first enters the birth canal). [1]
Shoulder presentations are uncommon (about 0.5% of births) [1] since, usually, toward the end of gestation, either the head or the buttocks start to enter the upper part of the pelvis, anchoring the fetus in a longitudinal lie. It is not known in all cases of shoulder presentation why the longitudinal line is not reached, but possible causes ...
Transverse – intersecting at any angle, i.e. not parallel. Orthogonal (or perpendicular) – at a right angle (at the point of intersection). Elevation – along a curve from a point on the horizon to the zenith, directly overhead. Depression – along a curve from a point on the horizon to the nadir, directly below.
According to Gabbe, "There is no place for internal podalic version and breech extraction in the management of transverse or oblique lie or unstable presentation in singleton pregnancies because of the unacceptably high rate of fetal and maternal complications." Podalic version has a long history spanning back to Hippocrates.
The right vertical limb of the "H" defines the left and right functional lobes, while the left vertical limb of the "H" defines the right and left anatomical lobes. The horizontal line between the vertical limbs of the "H" represents the porta hepatis. The quadrate and caudate lobe lie superior and inferior to this line respectively.