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Malpresentation And Malposition
Published in Vincenzo Berghella, Obstetric Evidence Based Guidelines, 2022
Alexis C. Gimovsky, Andrea Dall’Asta, Giovanni Morganelli, Tullio Ghi
Manual rotation of the persistent occiput posterior or transverse malposition of the cephalic presentation to the occiput anterior position in the second stage is associated with a nonsignificant 14% decrease in operative (OVD and CD) delivery.
Cephalopelvic Disproportion and Contracted Pelvis
Published in Gowri Dorairajan, Management of Normal and High Risk Labour During Childbirth, 2022
The recently published Cochrane review4 analysed the studies comparing X-ray pelvimetry with no pelvimetry or clinical pelvimetry. The authors concluded against the use of X-ray pelvimetry to decide the mode of delivery in women with cephalic presentation.
Umbilical Cord Prolapse
Published in Sanjeewa Padumadasa, Malik Goonewardene, Obstetric Emergencies, 2021
Sanjeewa Padumadasa, Prasantha Wijesinghe
The loop of the umbilical cord is compressed between the maternal pelvis and the presenting part, resulting in fetal hypoxia. This occurs even in occult cord prolapse. The degree of compression is greater in a cephalic presentation than in a non-cephalic presentation of the fetus. Furthermore, the umbilical cord vessels that are exposed to the colder temperature outside the vagina undergo vasospasm, which further reduces blood supply to the fetus. Total cord compression for more than 10 minutes can cause fetal cerebral damage, and more than 20 minutes of this can cause fetal death. The fetal condition can rapidly deteriorate if the fetus is already compromised, as in prematurity and fetal growth restriction.
Utilization of epidural volume extension technique for external cephalic version
Published in Baylor University Medical Center Proceedings, 2021
Hanna Hussey, James Damron, Mark F. Powell, Michelle Tubinis
Repeat ultrasound demonstrated breech presentation, normal amniotic fluid volume, and fetal head toward the maternal left abdomen. After 0.25 mg of intramuscular terbutaline injection, a forward roll was initiated by applying pressure from behind the fetal head toward the maternal left. Continuous progress was made and bedside ultrasound showed cephalic presentation. Immediately after successful ECV, the fetal heart rate was 70 beats/min but returned to baseline with conservative measures. Motor blockade regressed after approximately 1.5 hours. After 4 hours of fetal heart rate monitoring and tocometry, the patient was deemed stable for discharge. Follow-up discussion with the patient via phone call on postprocedure day 1 confirmed that she was not experiencing pain or concerning symptoms for neuraxial complications. She returned to the labor and delivery unit at 40 weeks’ gestation for elective induction of labor and had a successful vaginal delivery.
Complex maternal congenital anomalies – a rare presentation and delivery through a supra-umbilical abdominal incision
Published in Journal of Obstetrics and Gynaecology, 2018
Samantha Bonner, Yara Mohammed
She had a spontaneous conception and booked at 9 weeks of gestation under consultant-led care. A scan confirmed the pregnancy was in the right uterus. She had no other significant medical history but did suffer from recurrent urinary tract infections and hence was on low-dose antibiotic prophylaxis. There was no sonographic evidence of hydronephrosis. Her body mass index (BMI) was 18 at the time of booking. Combined screening was low risk and she had a normal 20 week anomaly scan. She had serial growth scans which demonstrated a normal growth trajectory on a customised chart. The baby was consistently a cephalic presentation. She had multidisciplinary antenatal care, including specialist urologists, general surgeons, obstetricians and anaesthetists. An antenatal MRI scan had shown extensive adhesions over the lower segment of the uterus. She was extensively counselled regarding the mode of delivery and this was scheduled at 37 weeks of gestation to avoid the potential of spontaneous labour and an emergency Caesarean section.
Inner Ear Malformations in Congenital Deafness Are Not Associated with Increased Risk of Breech Presentation
Published in Fetal and Pediatric Pathology, 2021
Slobodan Sekulic, Slobodanka Lemajic-Komazec, Ivana Sokolovac, Anastasia Topalidou, Olga Gouni, Branka Petkovic, Ljiljana Martac, Goran Kekovic, Tatjana Redzek-Mudrinic, Ivan Capo
We included only publications that described case reports or series (in humans) and provided information of fetal presentation in single-fetus pregnancies (singleton). In addition to the term “cephalic presentation”, the terms “uneventful birth”, “unremarkable birth history”, “normal vaginal delivery”, “uncomplicated delivery”, “normal delivery”, “uneventful perinatal” and “uneventful intranatal period”, were considered as cephalic presentation. Duplicate articles were automatically identified by the search tool and removed from the database prior to screening. Two authors reviewed the findings to reduce the risk of selection bias. First, the two reviewers screened the publications by title and abstract. Publications which fulfilled the inclusion criteria were screened in full text.