Silva, Marvin Jay A.

March 30, 2022

BSN – 2B OB (LEC)

Module 4
I. WORKSHEET:

COMPLETE THE TABLE BELOW ON THE DIFFERENT FETAL MALPRESENTATION

TYPES OF DESCRIPTIO MATERNA/ MANAGEMEN METHOD
MALPRESENTATI N FETALL RISKS T/ OF FETAL
ON TREATMENT DELIVER
Y
1. Face While lying Anencephaly, 1. Do not Face
Presentation on a hydrocephalus, fetal attempt to presentatio
longitudinal neck masses, convert face n is a
axis, the fetal cephalopelvic presentation to somewhat
head and neck disproportion, vertex. uncommon
are polyhydramnios, obstetric
hyperextended prematurity, low 2. Never apply occurrence,
, causing the birth weight, and vacuum and most
occiput to contracted pelvis. extractor for practitioner
come into Facial edema, skull face s will go
touch with the molding, breathing presentation. through
upper back of problems (due to their lives
the fetus. tracheal and 3. Do not apply without
laryngeal trauma), internal scalp ever
prolonged labor, electrodes. encounterin
fetal distress, spinal g one. Only
cord injuries, 4. Avoid if the
permanent brain oxytocin. foetus is in
damage, and the mentum
neonatal death. 5. Consider anterior
large episiotomy position
if fetus delivers can the
vaginally. face
presentatio
n be
delivered
vaginally.
Face
presentatio
 n is
delivered
via
caesarean
section in
more than
half of the
instances.
2. Sincipital Larger 1.Uterine 1. Leopold’s Cesarian
Presentation diameter of malformation. maneuvers may section
the fetal head 2. Placenta Previa help detect would be
is presented. 3. Weak uterine abnormal the best
During labor, contractions. presentation option.
the frontal 4. Oligohydramnion 2. Observe Forcing a
region of the 5. Prolonged latent closely for regular
skull, phase of labour. abnormal labor delivery
comprising 6. Prematurity patterns would
the forehead 7. Cord 3. Monitor FHR damage or
and top of the presentation. and contractions injured
head, is the continuously both
first to mother and
descend into baby.
the birth
canal.

3. Footling One or both of 1. Multiparity 1. Leopold’s Cesarian

breech the baby’s feet 2. Prematurity maneuvers may section
point 3. Uterine help detect would be
downward and malformations abnormal the best
will deliver 4. Polyhydramnios presentation option.
before the rest 5. Macrosomia 2. Observe Forcing a
of their body. 6. anencephaly closely for regular
7. Placenta praevia abnormal labor delivery
patterns would
3. Monitor FHR damage or
and contractions injured
continuously both
mother and
baby.
4. Shoulder The infant is 1. Anatomic 1. Leopold’s Cesarian
Presentation in a transverse abnormalities of the maneuvers may section
position (its pelvis. help detect would be
spinal column 2. Weakness of abnormal the best
 is abdominal muscles. presentation option.
perpendicular 3. Abnormalities of 2. Observe Forcing a
to that of the the uterus closely for regular
mother) (bicornuate or abnormal labor delivery
during septate). patterns would
birthing, and 4. Fibroids 3. Monitor FHR damage or
the leading 5. Pelvic masses and contractions injured
part (the part 6. Multiple continuously both
that enters the gestations mother and
birth canal 7. Polyhydramnios baby.
first) is an 8. Placenta previa.
arm, a 9.Prematurity
shoulder, or
the trunk.

II. Mrs. X went arrived at the outpatient department of Quezon Medical Center for prenatal
check-up, upon vaginal examination fetus is in Occiput transverse (OT) position. What
considerations should the nurse keep in mind in providing care for Mrs. X?

Considerations:
 To detect the malpresentation use Leopold’s maneuver.
 Monitor the FHR and contractions continuously.
 Manual rotation from the OP to the occiput anterior (OA) position is a safe, reasonably
straightforward, and simple to perform method that may minimize the rate of surgical
delivery (defined as vacuum, forceps, and/or caesarean section).
 Provide client support and encouragement.