10/1: Dystocia

Transverse Lie

baby is sideways, head and feet L/R - "oblique lie" or "shoulder presentation"
- undeliverable

Compound - Jack Benny Presentation

hand comes down along the head

Persisten O.P.

occiput posterior - usually mother's pelvis has a somewhat android she and it's easier for the head to go toward the back of the sacrum

Fetal Macrosoma

>4,500 g
as maternal nutrition gets worse, 5% of fetuses weigh at least 4,000 g

Birth Size

1. parents have a genetic influence on how big you are
2. maternal size has a special relationship to fetal size
3. birth order: babies tend to get bigger in a woman's subsequent pregnancies
4. diabetic mother - increasing circulatory level or glucose tha

Shoulder Dystocia

entrapment of the anterior shoulder after delivery of the head
- after the head is delivered, the anterior shoulder come out first when you pull down, then you pull up and the posterior shoulder comes out

turtle sign

the head pops back in even though you're trying to deliver it
*this is an obstetrical emergency - the baby can stop breathing, or can end up with nerve damage to the brachial plexus
- put direct pressure just behind the pubic bone w/ hand or fist & pop ou

Fetal Hydrocephalus

bigger than outlet
babies w/ abnormally large abdominal circumference - may actually be bigger than the head, which would make it difficult if not possible to deliver

Conjoined/Locked twins

one is breech and one is vertex, so they can't be extracted from their entanglement

Bony Pelvis

1. contraction problems - any contraction lessens the area in the pelvis
2. women w/ rickets - practically no space between the sacral promontory and back of the pubic symphysis
3. contraction of pelvic outlet, contraction of mid pelvis, any combo
4. skew

Soft Tissue Abnormalities

1. fat
2. benign tumors of the uterus
3. abnormalities of the cervix (from cancer, surgery, etc.)
4. ovarian tumors