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D (A) vertex (B) sinciput (C) brow (D) face
LOA LOP
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A. Right occiput posterior (ROP) Right occiput transverse (ROT)
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C Right occiput anterior (ROA).
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FREQUENCY OF VARIOUS PRESENTATIONS &
POSITIONS AT TERM
Vertex 96%
2/3 Lt
1/3 Rt
Breech 3.5%
Face 0.3%
Shoulder 0.4%
Lt mento-ant Rt mento-ant Rt mento-post
1-ENGAGEMENT
The greatest transverse diameter BPD passes through the
pelvic inlet
It may occur in the last few weeks of pregnancy or only in
labour especially in multipara
The fetus enters the pelvis in transverse or oblique diameter
LOT 40%
ROT 20%
OP 20% ROP >LOP
ROA / LOA 20%
THE CARDINAL MOVEMENTS OF LABOUR
Asynclitism
The sagittal sutures of the head deflects ant towards the
symphysis pubis or post towards the sacrum
2-DESCENT
In nullipara engagement takes place before the onset of
labour & further descent may not occur till the 2nd stage
In multipara descent begins with engagement
It is gradually progressive till the fetus is delivered
It is affected by the uterine contractions & thinning of the
lower segment
Anterior asynclitism Normal synclitism Posterior asynclitism
Naegele's obliquity Litzmann's obliquity Ear
presentation
3-FLEXION
The descending head meets resistance of pelvic floor, Cx
& walls of the pelvis flexion
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