GENETTE SOLIS

BSN-II E

MCN-3/11/16
Maam Pacial

PROBLEMS WITH THE

PASSENGER
1. PROLAPSE OF THE
UMBILICAL CORD

DESCRIPTION

2.

MULTIPLE GESTATION

3.

OCCIPITOPOSTERIOR
POSITION

PICTURE

a loop of the umbilical cord slips down in

front of the presenting fetal part.
Prolapse may occur at any time after the
membranes rupture if the presenting fetal
part is not fitted firmly into cervix.
It tends to occur most often with:
-premature rupture of membrane
-fetal presentation other than cephalic
-placenta previa
-small fetus
-hydramnios
-multiple gestation

Twins may be born by cesarean birth to decrease

the risk that the second fetus will experience
anoxia; because of the increased incidence of cord
entanglement and premature separation of the
placenta.
Be certain to assess the womans hematocrit level
and blood pressure closely during labor or while
waiting for the cesarean surgeon because anemia
and PIH occur higher-than-usual incidences during
multiple gestation.
Posterior position tend to occur in women with
android, anthropoid, or contracted pelves. It is
suggested by a dysfunctional labor pattern such
as a prolonged active phase, arrested descent, or
FHSound heard best at the lateral sides of the
abdomen.
The In these positions, during internal rotation,
the fetal head must rotate, not through a 90degree arc but through an arc of approximately
135 degrees.

REFERENCE:
Maternal and Child Health Nursing: Care of the Childbearing and Childrearing Family, Sixth Edition: Text and Study Guide Package by Adele Pillitteri

GENETTE SOLIS
BSN-II E
4.

BREECH PRESENTATION

MCN-3/11/16
Maam Pacial

5.

FACE PRESENTATION

There are several types of breech presentation:

Complete, frank and footling.
Breech is more hazardous than a cephalic
presentation because there is a higher risk of
-anoxia from a prolapsed cord
-traumatic injury to the aftercoming head
-fracture of the spine or arm
-early ROM because of the poor fit of presenting
part.

A fetal head presenting at the different angle

than expected and termed as asynclitism. The
head diameter the fetus presents to the pelvis is
often too large for birth to proceed.
When a face presentation is suspected, an UTZ
is done to confirm it; if indicated, and the pelvic
diameter are without difficulty.

-If the chin is posterior, cesarean birth is usually

the method of choice: otherwise it would be
necessary to wait for a long posterior-anterior
rotation to occur.
-They have a great deal of facial edema and may
be purple from ecchymotic bruising.

6.

BROW PRESENTATION

It is the rarest presentation. It occurs mostly in

multipara or a woman with relaxed abdominal
muscles. It almost invariably results in
obstructed labor, because the head becomes
jammed in the brim of the pelvis as the
occipitomental diameter presents.

REFERENCE:
Maternal and Child Health Nursing: Care of the Childbearing and Childrearing Family, Sixth Edition: Text and Study Guide Package by Adele Pillitteri

GENETTE SOLIS
BSN-II E

MCN-3/11/16
Maam Pacial

7.

TRANSVERSE LIE

8.

OVERSIZED FETUS
(MACROSOMIA)

Size may become a problem in a fetus who

weighs more than 4000 to 45000g. (9 to 10lb).
Babies of this size are most frequently born to a
women who enter pregnancy with diabetes or
develop gestational diabetes. Large babies are
also associated with multiparity, because each
infant born to a woman tends to slightly heavier
and larger than the one born just before.

9.

SHOULDER DYSTOCIA

The problem occurs at the second stage of

labor when the fetal head is born but the
shoulders are too broad to enter and be born
through the pelvic outlet.
It occurs mostly in women with diabetes,
multiparas and post-date pregnancies.

It occurs in women with pendulous abdomens,

with uterine fibroid rumors that obstruct the
lower uterine segment, with contraction of the
pelvic brim, with congenital abnormalities of
the uterus, or with hydramnios. It may occur
in infants with hydrocephalus or another
abnormality that prevents the head from
engaging.

REFERENCE:
Maternal and Child Health Nursing: Care of the Childbearing and Childrearing Family, Sixth Edition: Text and Study Guide Package by Adele Pillitteri

GENETTE SOLIS
BSN-II E
10. FETAL ANOMALIES

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Maam Pacial

Of the head such as hydrocephalus or

anencephaly can also complicate birth because
the fetal presenting part does not engage the
cervix well

REFERENCE:
Maternal and Child Health Nursing: Care of the Childbearing and Childrearing Family, Sixth Edition: Text and Study Guide Package by Adele Pillitteri