CORRECTION OF FAULTY FETAL PRESENTATION,

POSITION AND POSTURE

1.CARPAL FLEXION:

Presentation: Longitudinal anterior

Position: Dorso sacral

Posture: Unilaterally or bilaterally flexed carpal joint.

Correction: Repel the fetal head or shoulder, grasp the retained foot, push the carpus upwards
and carry the foot outwards and finally brought forwards in an arc over the pelvic brim and
extend alongside the other limb. If the condition is bilateral, repeat the procedure in the other
limb also.

2. INCOMPLETE EXTENSION OF THE ELBOWS:

Presentation: Longitudinal anterior

Position: Dorso sacral

Posture: The elbow joint (s) is/are incompletely extended so that the digits are at the level of
head.

Correction: Repel the fetal head, pull the limb and turn in obliquely upward direction. If the
condition is bilateral, repeat the procedure in the other limb also.
3. SHOULDER FLEXION:

Presentation: Longitudinal anterior

Position: Dorso sacral

Posture: Unilaterally or bilaterally flexed shoulder joint (s).

Correction: Repel the fetus, so that the retained forelimbs come forwards, grasp the radius
and ulna and convert it into carpal flexion posture. Then, grasp the retained foot, push the
carpus upwards and carry the foot outwards and finally brought forwards in an arc over the
pelvic brim and extend alongside the other limb. If the condition is bilateral, repeat the
procedure in the other limb also.

4. LATERAL DEVIATION OF THE HEAD:

Presentation: Longitudinal anterior

Position: Dorso sacral

Posture: The head is laterally deviated towards right or left.

Correction: Repel the fetus by pressing forwards at the base of the neck, firmly grasp the
muzzle of the calf and brought round through an arc until the nose is in line with the birth
canal.

5. DOWNWARD DISPLACEMENT OF THE HEAD:

A. Vertex posture

Presentation: Longitudinal anterior

Position: Dorso sacral

Posture: The head is displaced downwards so that the calf's nose abuts on the pubic brim and
the brow is directed into the pelvis.

Correction: Repel the fetus by applying pressure to the forehead by means of a thumb while
lifting the mandible over the pelvic brim with the fingers.
B. Nape presentation

Presentation: Longitudinal anterior

Position: Dorso sacral

Posture: The head is displaced downwards so that the poll region is directed into the pelvis.

Correction: Repel the fetus by applying pressure to the poll while lifting the mandible over
the pelvic brim with the fingers. If this procedure fails, replace one of the forelimbs into the
uterus, rotate the head laterally and bring it upwards and forwards over the pelvic brim. Then
extend the leg and apply traction. In difficult cases, go for caesarean (live fetus) or fetotomy
(dead fetus)

C. Breast head posture

Presentation: Longitudinal anterior

Position: Dorso sacral

Posture: The head is displaced downwards so that the back of the neck is directed into the
pelvis.

Correction: Replace one of the forelimbs into the uterus, rotate the head laterally and bring it
upwards and forwards over the pelvic brim. Then extend the leg and apply traction. In
difficult cases, go for caesarean (live fetus) or fetotomy (dead fetus).
6. NORMAL POSTERIOR PRESENTATION

Presentation: Longitudinal posterior

Position: Lumbo sacral

Posture: Hind limbs are extended.

Correction: If the tail is retroverted, correct it. Apply snares above the fetlock joints, repel
one leg, pull on the other so as to bring its stifle over the pelvic brim. The repelled limb can
also be presented to the pelvis similarly. Then apply gentle traction. If the fetal pelvis gets
jammed in the birth canal, repel the fetus, rotate through an angle of 45° and pull on again.
7. HOCK FLEXION:

Presentation: Longitudinal posterior

Position: Lumbo sacral

Posture: Unilaterally or bilaterally flexed hock joint (s).

Correction: Repel the fetus by pressing forward in its perineum, grasp the fetal foot. The foot
can be drawn back through an arc so that hock is firmly flexed. Cup the digits and lift the foot
over pelvic brim and thus the limbs can be extended in vagina.

8. BILATERAL HIP FLEXION (BREECH PRESENTATION):

Presentation: Longitudinal posterior

Position: Lumbo sacral

Posture: Bilaterally flexed hip joints

Correction: Repel the fetus by pressing forward and upwards in its perineum to bring the
retained limbs within reach. Grasp the limb near to the hock and apply traction to convert the
posture into hock flexion. Then, grasp the fetal foot. The foot can be drawn back through an
arc so that hock is firmly flexed. Cup the digits and lift the foot over pelvic brim and thus the
limbs can be extended in vagina. If the attempt fails, go for caesarean (live fetus) or fetotomy
(dead fetus).
9. DORSO TRANSVERSE PRESENTATION

Presentation: Dorsal transverse

Position: Right or left cephalo ilial

Posture: Dorsum of the fetus is directed towards the birth canal

Correction: Under epidural anaesthesia, with proper lubrication, the proximal extremity of the
fetus can be manipulated to turn the fetus into ventral position and anterior or posterior
presentation. Then rotate the fetus into dorsal position and apply traction. If the procedure
fails, immediately go for caesarean. Fetotomy is not indicated in such cases.

10. VENTRO TRANSVERSE PRESENTATION

Presentation: Ventral transverse

Position: Right or left cephalo ilial

Posture: Head and limbs of the fetus are directed towards the birth canal

Correction: Under epidural anaesthesia, with proper lubrication, convert it into posterior
presentation and ventral position. Then rotate the fetus into dorsal position and apply traction.
If the procedure fails, immediately go for caesarean. Fetotomy is not indicated in such cases.

11. OBLIQUE VENTRO VERTICAL PRESENTATION (DOG SITTING POSITION)

Presentation: Oblique ventro vertical

Position: Dorso sacral

Posture: Head and all the four limbs of the fetus are directed towards the birth canal

Correction: Under epidural anaesthesia, with proper lubrication, repel the fetus sufficiently to
allow the hind feet to be pushed off the pelvic brim into the uterus so that the fetus can be
converted to normal anterior presentation. Then, traction can be applied. If the procedure fails,
go for caesarean.