1 / 8

Who Needs a Caesarean Birth?

Who Needs a Caesarean Birth?. Max Brinsmead PhD FRANZCOG May 2008. Factors which influence the outcome of a trial of labour. The Passage The Passenger The Powers The Psyche. The Passages. Stature (and maybe shoe size!) Shape of the pelvis Gynecoid Android Anthropoid Platypelloid

carl-hancock
Download Presentation

Who Needs a Caesarean Birth?

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. Who Needs a Caesarean Birth? Max Brinsmead PhD FRANZCOG May 2008

  2. Factors which influence the outcome of a trial of labour • The Passage • The Passenger • The Powers • The Psyche

  3. The Passages • Stature (and maybe shoe size!) • Shape of the pelvis • Gynecoid • Android • Anthropoid • Platypelloid • Pelvic joint changes and position in labour • Soft tissues • An effect from parity • Maternal obesity

  4. The Passenger • Size • Presentation • Position • Adversely affected by epidural anaesthesia • Attitude • Flexed or deflexed • Moulding • Does this change with gestation?

  5. Estimating Birth Size • Notoriously inaccurate: • Ultrasound measures abdominal circumference typically +/- 20% • That is 2880 – 4320 g for average 3.6 Kg baby • Need to consider: • BW of previous babies • Mother’s size and weight gained in pregnancy • Mother’s own birthweight • Ethnicity • Father’s size

  6. Estimating Pelvic Size • Clinical pelvimetry • Unreliable • X-ray or CT pelvimetry • Abandoned • “The best pelvimeter is the baby” • Engagement of the head before labour • Engagement and descent in labour • “Trial of labour” • Pelvic soft tissues are more important?

  7. The Powers • The effect of parity • Maternal age • An effect from posture • Upright position in labour • Fetal back uppermost when lying • Induction of labour • Augmentation of labour • Amniotomy • Oxytocin infusion

  8. The Psyche • The place of birth • Maternal anxiety • Analgesia in labour • Preparation for birth • The role of a doula

More Related