**Article on Fetal Presentation, Labor, and Postpartum**

This article will provide basic knowledge about fetal presentation, labor, and postpartum, which is essential for pregnant women and healthcare professionals.

1. Fetal Presentation

Fetal presentation refers to the position of the fetal presenting part in relation to the maternal pelvis.

• Attitude: This describes the relationship between the fetal landmark and the anterior-posterior position of the maternal pelvis.

• Lie: This describes the relationship between the fetal landmark and the left-right position of the maternal pelvis.

• Degree of Flexion: This applies only to vertex presentation and defines the degree of flexion of the fetal head.

Vertex Presentation:

• This is the most common fetal presentation, accounting for 95% of labors.

• The landmark for vertex presentation is the posterior fontanel.

• There are two attitudes: occiput anterior and occiput posterior.

• There are four lie variations: left occiput anterior, right occiput anterior, left occiput posterior, and right occiput posterior.

• There are two lie positions: left transverse and right transverse.

Face Presentation:

• This is a fetal presentation where the head is maximally extended.

• The landmark for face presentation is the chin.

• There are two attitudes: mentum anterior and mentum posterior.

Brow Presentation:

• This is a fetal presentation where the head is in an intermediate position.

• The landmark for brow presentation is the nose.

Assessing Fetal Presentation:

• Vaginal Examination: The fetal landmark can be identified when the cervix is dilated.

• External Abdominal Palpation: This is used to make a preliminary diagnosis of fetal presentation.

Mechanism of Labor for Vertex Presentation:

• This involves four stages: engagement, descent, rotation, and expulsion.

• First Stage of Labor: The suboccipitobregmatic diameter passes through the pelvic inlet.

• Second Stage of Labor: The biparietal diameter passes through the right oblique diameter of the pelvic inlet.

• Third Stage of Labor: The anteroposterior diameter passes through the pelvic outlet.

Determining Attitude of Vertex Presentation:

• The position of the posterior fontanel is used to determine the attitude.

• If the posterior fontanel is at the 2 o’clock position, the attitude is left occiput anterior.

• If the posterior fontanel is at the 7 o’clock position, the attitude is right occiput posterior.

Engagement:

• This is used to assess if the fetal presentation can pass through the pelvic inlet, especially in cases of suspected cephalopelvic disproportion.

• Engagement refers to the degree of descent of the presenting part.

2. Labor

Labor is the process of physiological changes in the mother’s body to expel the fetus. It consists of three stages:

• Stage 1 (Cervical Effacement and Dilation): This stage begins when the cervix starts to efface and dilates until it is fully dilated.

• Stage 2 (Expulsion): This stage begins when the cervix is fully dilated until the fetus is delivered.

• Stage 3 (Placental Delivery): This stage begins when the fetus is delivered until the placenta detaches and is delivered.

Uterine Contractions:

• This is the main driving force of labor.

• They usually originate in one uterine horn and then spread throughout the uterus.

• There are four factors: frequency, intensity, duration, and efficiency.

Monitoring Labor:

• Labor is monitored using a partograph.

• The partograph has three sections: cervical dilation, fetal descent, and fetal heart rate.

• Labor progress is recorded using specific symbols.

Concerns in Labor:

• Fetal Distress: Fetal heart rate below 110 beats per minute or above 160 beats per minute for more than 10 minutes.

• Prolonged Labor: Stage 1 longer than 12 hours, Stage 2 longer than 2 hours.

• Postpartum Hemorrhage: Excessive vaginal bleeding after delivery of the fetus and placenta.

3. Postpartum

The postpartum period refers to the recovery period of the mother’s body after childbirth.

• Uterine Changes: The uterus contracts, constricts, and involutes.

• Lochia: This is the discharge from the vagina, cervix, and uterine lining, containing shed decidual cells, blood clots, etc.

• Lactation: This is initiated by the secretion of prolactin and the suckling action.

Concerns in Postpartum:

• Postpartum Hemorrhage: Excessive vaginal bleeding after delivery.

• Postpartum Infection: Infection of the uterus, vagina, etc.

• Postpartum Urinary Retention: Inability to urinate for 12 hours after delivery.

Conclusion

Fetal presentation, labor, and postpartum are crucial aspects of pregnancy and childbirth. Understanding these concepts allows pregnant women and healthcare professionals to closely monitor the pregnancy and postpartum periods, facilitating timely interventions and ensuring the health of both mother and baby.