NIRO, IRISH PAULENE M.

MCN 107 - LECTURE

BSN 2 - LYDIA HALL MATERNAL AND CHILD
COMPONENTS OF LABOR

PASSENGER FONTANELLE
● Refers to the fetus or the baby ● Membranous spaces in between the
suture lines
HEAD - has the largest diameter ● From digital and coronal
● Comprises of 8 bones ● Diamond anterior shape
4 SUPERIOR BONES ● Anteroposterior - vertical line
● Frontal - Longer transverse (2.3cm)
● 2 parietal
● Occipital ANTERIOR FONTANELLE
OTHER 4 BONES ➢ BREGMA -
● Sphenoid bone ● formed by sagittal suture and
● Ethmoid bone coronal suture
● 2 temporal bones ● They have diamond shape
wherein the
SUTURE LINE ● anteroposterior diameter
● These are bones that tends to (APT - vertical line) is longer
overlap each other to decrease the than the transverse diameter
size of the fetal skull (horizontal)
● Facilitating the delivery of the fetal ● APT is 3-4 cm
head out from the birth canal ● Transverse is 2-3 cm
● During delivery changes ● Closes between 12 to 18
➢ 3 types months
● Sagittal - located in between
two parietal POSTERIOR FONTANELLE
● Coronal - between frontal ➢ LAMBDA
and parietal ● Formed by Sagittal and
● Lambdoidal - between Lambdoial suture fontanelle
occipital and two parietal ● Triangular in shape
● APT - 2 cm apart
● Closes at 2 months

SINCIPUT
➢ Covers the frontal bone

BREGMA
➢ Space in between the anterior and
posterior fontanelle

VERTEX
● Space between the two fontanelle
OCCIPUT ➢ OCCIPITOMENTAL DIAMETER
● Covers the occipital bone ● Widest anteroposterior
diameter
● Approximately 13.5 cm
● Measured from the chin to
the posterior fontanelle

DIAMETER OF THE SKULL

● Measurement is taken in 3 weeks
● The shape of the skull causes it to
be wider in its anteroposterior
diameter than in its transverse BIPARIETAL
diameter ● Measurement is 9.25cm
● To fit to the birth canal, the fetus ● Presenting the narrowest diameter
must present the smaller diameter
(transverse diameter) to the smaller
diameter of the maternal pelvis
● The diameter of the anteroposterior
fetal skull depends on where the
measurement is taken

➢ SUBOCCIPITOBREGMATIC
DIAMETER
● Has the favorable
measurement FETAL PRESENTATION
● Approximately 9.5 cm ● Denotes the body part that is in 1st
● From the inferior aspect of contact to the cervix
the occiput to the center of
the anterior fontanelle CEPHALIC PRESENTATION
● Narrowest diameter 1. Vertex - most favorable

➢ OCCIPITOFRONTAL DIAMETER ● A fetus is in a

● From the bridge of the nose headfirst, head down
to the occipital prominence position with its chin tucked
● Approximately 12cm towards its chest, facing your
supine.

2. Brow
● The fetal head is
midway between full flexion
(vertext) and
hyperextension (face) along
a longitudinal axis
3. Face/ chin
● A rare unanticipated
obstetric event
characterized by a ●
longitudinal lie and full
extension of the fetal head
on the neck with the occiput
against the upper back
● On vaginal examination, the face is
palpated, the examiner’s finger
enters the mouth easily and the
bony jaws are felt
● Prolonged labour is common
● Descent and delivery of the head by
flexion may occur in the chin-anterior
position.
● In the chin-position, however, the
fully extended head is blocked by
the sacrum. This prevents descent
and labour is impossible (caesarean
section)
● The chin serves as the reference
point in describing the position of the
head
It is necessary to distinguish only
chin-anterior positions in which the
chin is anterior in relation to the
maternal pelvis from chin-posterior
positions.

FACE
● Lead to prolong labor, soft
● There will be facial edema and
discoloration of the skin after
delivery because the force of the
uterine contraction to the presenting
part
● Affect brestfeeding

MENTUM/CHIN
● Lead also to prolong labor

FACE PRESENTATION
● Is caused by hyperextension of the
fetal head so that neither the occiput
nor the sinciput are palpable on
vaginal examination
● On abdominal examination, a groove
may be felt between the occiput and
the back
BREECH PRESENTATION FETAL LIE
● Relationship between the long axis
NOTE:
● Meconium staining for breech is of the fetal body and the long axis of
NORMAL the woman’s body
● Longitudinal - cephalic and breech
● Transverse - shoulder presentation
Frank breech - the baby’s bottom
● Oblique - diagonal
comes first, and the legs are flexed
at the hip and extended at the knees
(with feet near the ears). 65 - 70% of
breech babies are in the frank
breech position.

Complete breech - the baby’s hips

and knees are flexed so that the
baby is sitting cross legged, with feet ATTITUDE
beside the bottom. ● Degree of flexion the fetus assumes
during labor
➢ Good flexion
Convex back
Arms are flexed to the
abdomen
➢ Moderate Flexion
Chin is not touching the
chest
Footling breech - footling breech
Military position
one or both feet come first, with the
➢ Partial extension
bottom at a higher position. This is
rare at term but relatively common Presents the brow of the
with premature fetuses. head to the birth canal
➢ Back is arched/concave
Neck is extended
Occipitomental diameter is
being presented to the birth
canal/ face presentation
STATION ● Anteriorly (A).
● Relationship of the presenting part to ● Posterioly (P),
the schial spine ● Transversely (T)
● If reached Schial spine is 0 station -
the baby is already engaged
● Above the 0 station - the negative
numbers
The baby is floating
The baby is already
descended but haven’t reach
the schial spine
➢ -1 station (the baby is 1cm above
schial spine)
➢ -2 (2cm above the schial spine)
➢ +1 station ( 1cm below schial spine)
➢ +3 (already crowning)
➢ +4 (head is already out)
➢ Assessed through internal exam

POSITION

LOA
● Is the relationship of the presenting
part to a specific quadrant of the
woman’s pelvis
➢ 1st letter = defines the landmark of
the mother
● right (R) left (L)
➢ 2nd letter = denotes fetal landmark
● O- occiput
● M- mentum
● A – acromium
● Sa – sacrum
➢ 3rd letter = defines whether the
landmark points