Which of the following fetal positions is considered ideal and is most conducive to a birth that requires few interventions by the obstetrician?
During labor and delivery, your baby must pass through your pelvic bones to reach the vaginal opening. The goal is to find the easiest way out. Certain body positions give the baby a smaller shape, which makes it easier for your baby to get through this tight passage. Show The best position for the baby to pass through the pelvis is with the head down and the body facing toward the mother's back. This position is called occiput anterior. InformationCertain terms are used to describe your baby's position and movement through the birth canal. FETAL STATION Fetal station refers to where the presenting part is in your pelvis.
In first-time moms, the baby's head may engage by 36 weeks into the pregnancy. However, engagement may happen later in the pregnancy, or even during labor. FETAL LIE This refers to how the baby's spine lines up with the mother's spine. Your baby's spine is between his head and tailbone. Your baby will most often settle into a position in the pelvis before labor begins.
FETAL ATTITUDE The fetal attitude describes the position of the parts of your baby's body. The normal fetal attitude is commonly called the fetal position.
Abnormal fetal attitudes include a head that is tilted back, so the brow or the face presents first. Other body parts may be positioned behind the back. When this happens, the presenting part will be larger as it passes through the pelvis. This makes delivery more difficult. DELIVERY PRESENTATION Delivery presentation describes the way the baby is positioned to come down the birth canal for delivery. The best position for your baby inside your uterus at the time of delivery is head down. This is called cephalic presentation.
If your baby is in any position other than head down, your doctor may recommend a cesarean delivery. Breech presentation is when the baby's bottom is down. Breech presentation occurs about 3% of the time. There are a few types of breech:
The shoulder, arm, or trunk may present first if the fetus is in a transverse lie. This type of presentation occurs less than 1% of the time. Transverse lie is more common when you deliver before your due date, or have twins or triplets. CARDINAL MOVEMENTS OF LABOR As your baby passes through the birth canal, the baby's head will change positions. These changes are needed for your baby to fit and move through your pelvis. These movements of your baby's head are called cardinal movements of labor. Engagement
Descent
Flexion
Internal Rotation
Extension
External Rotation
Expulsion
Alternative NamesShoulder presentation; Malpresentations; Breech birth; Cephalic presentation; Fetal lie; Fetal attitude; Fetal descent; Fetal station; Cardinal movements; Labor-birth canal; Delivery-birth canal Images
ReferencesBarth WH. Malpresentations and malposition. In: Landon MB, Galan HL, Jauniaux ERM, et al, eds. Gabbe's Obstetrics: Normal and Problem Pregnancies. 8th ed. Philadelphia, PA: Elsevier; 2021:chap 17. Kilpatrick SJ, Garrison E, Fairbrother E. Normal labor and delivery. In: Landon MB, Galan HL, Jauniaux ERM, et al, eds. Gabbe's Obstetrics: Normal and Problem Pregnancies. 8th ed. Philadelphia, PA: Elsevier; 2021:chap 11. Review Date 12/3/2020Updated by: LaQuita Martinez, MD, Department of Obstetrics and Gynecology, Emory Johns Creek Hospital, Alpharetta, GA. Also reviewed by David Zieve, MD, MHA, Medical Director, Brenda Conaway, Editorial Director, and the A.D.A.M. Editorial team. What is the most ideal fetal position?The optimal position is Occipito-Anterior and this is the most effective way for a baby to journey through the maternal pelvis. In the OA position, your baby is head down with his or her face looking at your spine. In the OP position, your baby is head down, facing your naval.
What baby position is best for delivery?Once the baby is head down, the best position for a labour is the anterior position. Anterior position means the baby's head enters the pelvis facing your back. This is the ideal and most common position for birth (see image).
Is Roa or Loa better?Rest assured, the ROA fetal position is as good as the LOA position. It's believed the left anterior position is 'better' because, in most women, the uterus is slightly larger on the left side, so babies look for the most comfortable space.
Which fetal position is most desirable and why?The best position for your baby to be in for labour and birth is head down, facing your back - so that their back is towards the front of your tummy. This is called the occipito-anterior position. It allows them to move more easily through the pelvis.
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