1 / 17

FACE PRESENTATION

FACE PRESENTATION. DIGNOSTIC LANDMARKS-EYES,NOSE MOUTH AND CHIN POSITION-MENTO ANTERIOR/POSTERIOR,MENTO TRANSVERSE MANAGEMENT GUIDELINES-FETUS IS DEAD OR ALIVES WITH ANOMALIES INCOMPATABLE WITH LIFE,ALLOW VAGINAL DELIVERY MENTO ANTERIOR ,R/O FPD . FACE PRESENTATION AND BROW.

enid
Download Presentation

FACE PRESENTATION

An Image/Link below is provided (as is) to download presentation Download Policy: Content on the Website is provided to you AS IS for your information and personal use and may not be sold / licensed / shared on other websites without getting consent from its author. Content is provided to you AS IS for your information and personal use only. Download presentation by click this link. While downloading, if for some reason you are not able to download a presentation, the publisher may have deleted the file from their server. During download, if you can't get a presentation, the file might be deleted by the publisher.

E N D

Presentation Transcript


  1. FACE PRESENTATION • DIGNOSTIC LANDMARKS-EYES,NOSE MOUTH AND CHIN • POSITION-MENTO ANTERIOR/POSTERIOR,MENTO TRANSVERSE • MANAGEMENT GUIDELINES-FETUS IS DEAD OR ALIVES WITH ANOMALIES INCOMPATABLE WITH LIFE,ALLOW VAGINAL DELIVERY • MENTO ANTERIOR ,R/O FPD

  2. FACE PRESENTATION AND BROW IF LABOUR IS PROGRESSING WELL MENTO POSTERIOR- C/S BROW -NORMALLY INCOMPATABLE WITH VAGINAL DELIVERY DIAGNOSTIC LANDMARKS-ROOT OF THE NOSE,SUPRAORBITAL RIDGES,ANTERIOR FONTANEL MANAGEMENT - CESARIAN SECTION

  3. SHOULDER PRESENTATION • DIAGNOSTIC LANDMARKS • UTERUS IS ENLARGED TRANSVERSLY AND SHORTENED VERTICALLY • EMPTINESS AT THE LOWER POLE • ON PV PALPABLE CLAVICLE ,RIBS ARM PROLAPSE

  4. MANAGEMENT • WITH FETUS ALIVE –C/SECTION • WITH FETUS DEAD-DESTRUCTIVE OPERATION,OR C/S • COMPOUND PRESENTAION • PROLAPSE OF ONE OR MORE LIMBS IN CEPHALIC PRESENTATION • PROLAPSE OF HAND OR ARM IN BREECH PRESEENTATION

  5. COMPOUND PRESENTATION • PUSH THE HAND ABOVE THE FETAL HEAD • ARM MAY BE DIFFICULT TO REPLACE AND CESARIAN SECTION MAY BE NECESSARY • MALPOSITION • INCORRECT POSITIONING OF THE VERTEX • OCCIPITO POSTERIOR POSITION • PERSISTENT O.P.P

  6. 0CCIPITO POSTERIOR POSITION • DIAGNOSIS • PALPATION • AUSCULTATION • VAGINAL EXAMINATION • LONG ROTATION-135° --OCCIPITO ANTERIOR-SVD EXPECTED • SHORT ROTATION- 45°--FACE TO PUBIS—AVD OR C/SECTION

  7. MALPRESENTATION ANY PRESENTATION OTHER THAN THE NORMAL VERTEX OF THE FETAL HEAD

  8. MALPRESENTAION • FACE • BROW • SHOULDER • BREECH • COMPOUND

  9. CAUSES OF MALPRENTATION • HIGH PARITY • PREMATURITY • FETAL ANOMALIES • POLYHYDRAMNIOS • MILD CPD

  10. BREECH PRESENTATION WHEN THE BUTTOCKS AND/OR THE FEET ARE THE PRESENTING PARTS THE COMMONEST MALPRESENTATION HAS HIGHER PERINATAL MORTALITY AND MORBIDTY CAUSES OF BREECH PRESENTATION-PREMATURITY,MULTIPLE PREGNANCY,FETAL MALFORMATION,HYDRAMNIOUS

  11. CLASSIFICATION AND RISKS • COMPLETE • FRANK • FOOTLING • INTRAPARTUM RISK TO THE FETUS-CORD ACCIDENTS,FRACTURE AND DISLOCATION OF LIMBS,DAMAGE TO INTRA-ABDOMINAL ORGANS,INTRACRANIAL HAEMORRHAGE,DAMAGE TO THE CERVICAL SPINE AND BRACHIAL PLEXUS

  12. MANAGEMENT • UNCOMPLICATED BREECH • ELECTIVE C/S? • PLANNED VAGINAL DELIVERY? FRANK BREECH • C0MPLETE BREECH • FOOTLING

  13. VAGINAL DELIVERY • KEEP MEMBRANES INTACT AS LONG AS POSSIBLE • BREECH IS SMALLER THAN THE AFTER COMING HEAD • BEFORE BEARING DOWN THE CERVIX MUST BE FULLY DILATED • LET THE BREECH DESCEND TO THE PERINEUM

  14. ANATOMICAL LANDMARKS • ANTERIOR BUTTOCKS BEGIN TO DISTEND PERINEUM- ACTION? THEN POSTERIOR BUTTOCKS- ACTION? • HIPS –LEGS FLEXED- ACTION? • HIPS- LEGS EXTENDED-ACTION? • UMBILICUS- ACTION? • SCAPULA- ACTION? • NAPE OF THE NECK-ACTION?

  15. SPECIAL MANOEUVRES • PINARDS • MAURICEAU-SMELLIE-VEIT • LØVESET • PRAGUE • REVERSE PRAGUE • FORCEPS

  16. Complications of breech delivery • EXTENDED ARMS • NUCHAL ARM • OCCIPUT POSTERIOR OF THE AFTERCOMING HEAD • HEAD ENTRAPMENT BY INCOMPLETELY DILATED CERVIX

  17. BREACH EXTRACTION • IS THERE A PLACE FOR BREECH EXTRACTION?

More Related