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Fundus Latin word for bottom. In OB, fundus is the base of the uterus
Symphysis pubis - The area in the front of the pelvis where the pubic bones (the two bones of the pubis) meet.
FETAL ATTITUDE
- describes the degree of flexion a fetus assumes during labor or the relation of the fetal parts to each other. Suboccipito-bregmatic (Vertex) good attitude because of complete flexion: spine is bowed forward, head flexed forward so much that the chin touches the sternum, the arms are flexed and folded on the chest, thighs are flexed onto the abdomen.
position
Occipitomental poor flexion, complete extension of the head to the birth canal
This
position occurs if the amount of amniotic fluid is less than normal which does not allow the fetus adequate movement.
FETAL PRESENTATION - denotes the body part that will first contact the cervix or be born first.
Cephalic presentation the fetal head is the body part that will first contact the cervix. Breech presentation either the buttocks or the feet are the first body parts that will contact the cervix. Shoulder presentation a fetus lie horizontally in the pelvis. The presenting part is usually one of the shoulder (acromion process), an iliac crest, a hand, or an elbow
Complete breech the fetus thighs tightly flexed on the abdomen; both the bottocks and the tigthly flexed feet present to the cervix
Incomplete Breech
Frank Breech presentation attitude is moderate because the hips are flexed but the knees are extended to rest on the chest. The buttocks alone present to the cervix.
Footling Breech presentation neither the thighs nor the lower legs are flexed. If one foot is presents, it is a single-footling breech; if both present, it is a double-footling breech.
Shoulder Presentation
Fetal Position
Position is the relationship of the presenting part to the specific quadrant of a womans pelvis The maternal pelvis is divided into for quadrant according to mothers right and left
a. b. c. d.
Four parts of a fetus have been chosen as landmark to describe the relationship of the presenting part to one of the pelvic quadrants:
a. b. c. d.
OCCIPUT in vertex position CHIN (MENTUM) in face presentation SACRUM in breech presentation SCAPULA or the ACROMION in shoulder presentation
Examples:
LEFT MENTOTRANSVERSE
LEFT OCCIPUTOANTERIOR
LEFT SACROPOSTERIOR
FETAL POSITION
McDONALDS RULE
A symphysis-fundal height measurement is a common method of determining, during midpregnancy, that a fetus is growing in utero. The distance from the uterine fundus to the symphysis pubis in centimeter is equal to the week of gestation between 20th-31st weeks of pregnancy. 12 weeks AOG symphysis pubis 20 weeks AOG umbilicus 36 weeks AOG xiphoid process
LEOPOLDS MANEUVERS
Are a systematic method of observation and palpation to determine fetal presentation and position.
PROCEDURES
PREPARE THE CLIENT
Explain
the procedure Instruct the client to empty he bladder Position the woman supine with knees slightly flexed. Place a small pillow or rolled towel under one side. Wash your hands using warm water. Observe the womans abdomen for longest diameter and where fetal movement is apparent.
at the foot of the client, facing her and place both hands flat on her abdomen. Palpate the superior surface of the fundus. Determine the consistency, shape and mobility.
grasp the lower portion of the abdomen just above the symphysis pubis between the thumb and the index finger together. Determine any movement and whatever the pat firm or soft.
finger on the both sides of the uterus approximately 2 inches above the inguinal ligament, pressing downward and inward in the direction of the birth canal. Allow fingers to be carried downward.