Small transverse size of the head. mature fruit head
The skull of the fetus consists of two frontal, two parietal, two temporal, one occipital, sphenoid and ethmoid bones. Highest value V obstetric practice have the following seams:
▲ sagittal (sagittal) suture connects the right and left parietal bones; in front, the seam passes into the anterior (large) fontanelle, in the back - into the small (rear);
▲ the frontal suture is located between the frontal bones (in a newborn
▲ frontal bones have not yet grown together);
▲ The coronal suture connects the frontal bones with the parietal and is located perpendicular to the sagittal and frontal sutures. The coronal suture connects the frontal bones with the parietal and runs perpendicular to the sagittal and frontal sutures;
▲ lambdoid (occipital) suture connects the occipital bone with the parietal.
Fontanelles are located at the junction of the seams. The anterior and posterior fontanelles are of practical importance.
The anterior (large) fontanel is located at the junction of the sagittal, frontal and coronal sutures. It has a diamond shape and four sutures extend from it: anteriorly - frontal, posteriorly - sagittal, to the right and left - coronal sutures.
The posterior (small) fontanel is a small depression in which the sagittal and lambdoid sutures converge. It has a triangular shape. Three sutures depart from the posterior fontanel: anteriorly - sagittal, to the right and left - the corresponding sections of the lambdoid suture.
For practical obstetrics, it is also important to know the tubercles that are located on the head: the occipital, two parietal and two frontal.
Knowledge of the topographic and anatomical features of the fetal bone head is very important for practical obstetrics, since the doctor is guided by these cognitive points in the production of a vaginal examination during childbirth.
No less important than the sutures and fontanelles are the dimensions of the head of a mature and full-term fetus - each moment of the mechanism of childbirth corresponds to a certain size of the fetal head, at which it passes birth canal.
The small oblique size goes from the suboccipital fossa (this fossa is located under the occipital protuberance) to the anterior angle of the large fontanel and is 9.5 cm. The head circumference corresponding to this size is the smallest of all head circumferences - 32 cm.
The average oblique size - from the suboccipital fossa to the anterior border of the scalp - is 10.5 cm, the head circumference for this size is 33 cm.
Direct size - from nose to occiput- equal to 12 cm, head circumference in direct size 34 cm.
The large oblique size - from the chin to the most protruding part of the head at the back of the head - is 13-13.5 cm, the circumference of the head along the large oblique size is 38-42 cm.
Vertical dimension - from the top of the crown (crown) to hyoid bone- equal to 9.5 cm. The circumference corresponding to this size is 32 cm.
The large transverse dimension - the largest distance between the parietal tubercles - is 9.25 cm.
The small transverse dimension - the distance between the most distant points of the coronal suture - is 8 cm.
Usually, after the birth of a child, along with the dimensions of the head, the dimensions of the shoulder girdle are also measured. On average, the size of the shoulders (diameter of the shoulder girdle) is 12 cm, and their circumference is 35 cm.
head segments. In obstetrics, it is customary to distinguish between segments of the head - large and small.
The large segment of the head is its largest circumference, with which it passes through various planes of the small pelvis during childbirth. The very concept of "large segment" is conditional and relative. Its conditionality is due to the fact that the largest circumference of the head, strictly speaking, is not a segment, but a circle of a plane that conditionally cuts the head into two segments (large and small). The relativity of the concept lies in the fact that, depending on the presentation of the fetus, the largest circumference of the head, passing through the planes of the small pelvis, is different. Yes, at bent position heads ( occiput presentation) its larger segment is a circle passing in a plane of small oblique size. With moderate extension (anterocephalic presentation), the circumference of the head passes in the plane straight size, at maximum extension (facial presentation) - in the plane of vertical size.
Any segment of the head that is smaller in volume than the large segment is a small segment of the head.
A. Main literature:
1. Obstetrics /Ed. G.M. Savelyeva - M., 2001.
2. Ailamazyan E.K. "Obstetrics". 1997;
3. Obstetrics. Workshop. / Under the editorship of V.E. Radzinsky. M., 2002.
b.) Additional reading:
1. Abramchenko V,V. Classical obstetrics - St. Petersburg: "Elbi-SPb" - 2007. 808s.
2. Obstetrics: National leadership./ Ed. E.K.Ailamazyan, V.I.Kulakov, V.E.Radzinsky, G.M.Saveleva - M.: GEOTAR-Media, 2007 - 1200s.
3. Obstetrics from ten attendants. Translated from English / Under the editorship of S. Campbell, K. Lisa - M .: Med. Inform agency, 2004. -464s.
4. Guidelines for outpatient care in obstetrics and gynecology - M.: GEOTAR-Media, 2007 - 1072p.
5. Serov V.I. Obstetrics: Textbook. M.: Medpress.-2010
6. Guide to outpatient care in obstetrics and gynecology / Ed. V.I. Kulakov V.I., Prilepskaya V.N., V.E. Radzinsky. M., GOETAR-Media. 2006, 1056s.
In prenatal development of a person, two periods are distinguished: embryonic and fetal. Embryonic continues from the moment of fertilization to 9 weeks of pregnancy, during this period the rudiments of all organs and systems are formed. The fetal period lasts from 9 weeks of gestation until the birth of the fetus.
During pregnancy, a fertilized egg develops into a mature fetus capable of extrauterine existence. The maturity of a developed baby is judged by a combination of a number of signs: length, body weight, shape of the chest, location of the umbilical ring, skin and subcutaneous fat, condition of the ear and nasal cartilages, genitals, motor activity of the newborn.
The study of the shape and size of the fetal head is of particular importance in obstetrics. In the vast majority of births (96%), the head first passes through the birth canal, making a series of successive movements (turns).
The head, due to its density and size, experiences the greatest difficulties in passing through the birth canal. After the birth of the head, the birth canal is usually sufficiently prepared to advance the trunk and limbs of the fetus. The study of the head is important for the diagnosis and prognosis of childbirth: the location of the sutures and fontanelles is used to judge the mechanism of childbirth and their course.
The head of a mature fetus has a number of features. The facial bones of the fetus are firmly connected. The bones of the cranial part of the head are connected by fibrous membranes, which determine their known mobility and displacement relative to each other. These fibrous membranes are called seams. Small spaces at the intersection of the seams are called fontanelles. The bones in the area of the fontanelles are also connected by a fibrous membrane. As the head passes through the birth canal, the sutures and fontanelles allow the bones of the skull to overlap. The bones of the fetal skull bend easily. These features of the structure of the bones give the head of the fetus plasticity, i.e. the ability to change shape, which is extremely important for its passage through the birth canal.
The fetal skull is made up of two frontal, two parietal, two temporal and one occipital, main and ethmoid bones. in obstetrics special meaning have the following seams:
arrow seam(sutura sagitalis) passes between the parietal bones. In front, the seam passes into a large fontanelle, in the back - into a small one.
frontal suture(sutura frontalis) is located between the frontal bones; has the same direction as the swept seam.
Coronal suture(sutura caronalis) connects the frontal bones with the parietal, runs perpendicular to the sagittal and frontal sutures.
lambdoid(occipital) suture (sutura lambdoidea) connects the occipital bone with the parietal.
Fontanelles (spaces free from bone tissue). Of practical importance is the large and small fontanelles.
Large (anterior) fontanel(fonticulus magnus s. anterior) is located at the junction of the sagittal, frontal and coronal sutures, has a diamond shape. Four sutures extend from the large fontanel: frontal sutures anteriorly, swept posteriorly, corresponding sections of the coronal suture to the right and left.
Small (posterior) fontanel(fonticulus parvus, s posterior) is a small depression in which the sagittal and lambdoid sutures meet. The small fontanel has a triangular shape; three sutures depart from the small fontanel: anteriorly swept, to the right and left the corresponding sections of the lambdoid suture.
There are four secondary fontanelles: two each on the right and left sides of the skull. Pterygoid fontanel(pterion) is located at the junction of the parietal, main, frontal and temporal bones. stellate fontanel(asterion) is located at the junction of the parietal, temporal and occipital bones. These fontanelles have no special diagnostic value.
It is important to know the following tubercles on the fetal head: occipital, two parietal, two frontal.
Dimensions of the head of a mature fetus:
1. Straight size(diameter fronto-occipitalis) - from the glabella (glabella) to the occiput - is 12 cm. Head circumference in direct size (circumferentia fronto-occipitalis) - 34 cm.
2. Large oblique size(diameter mento-occipitalis) - from the chin to the occiput - is 13-13.5 cm. The head circumference for this size (circumferentia mento-occipitalis) is 38-42 cm.
3. Small oblique size(diameter suboccipito-bregmaticus) - from the suboccipital fossa to the first corner of the large fontanel - is 9.5 cm. The head circumference corresponding to this size (circumferentia suboccipito-bregmatica) is 32 cm.
4. Medium oblique size(diameter suboccipitio-frontalis) - from the suboccipital fossa to the border of the scalp of the forehead - is 10 cm. The head circumference for this size (circumferentia suboccipito-frontalis) is 33 cm.
5. Sheer or vertical dimension(diameter verticalis, s. trashelo-bregmaticus) - from the top of the crown (crown) to the sublingual region - is 9.5-10 cm. The head circumference corresponding to this size (cipcumferentia trashelo-bregmatica), 32 cm.
6. Large transverse dimension(diameter biparietalis) - the largest distance between the parietal tubercles is 9.25-9.5 cm.
7. Small transverse dimension(diameter bitemporalis) - the distance between the most distant points of the coronal suture - 8 cm.
Body dimensions:
1. The size of the coat hanger- the diameter of the shoulder girdle (diameter biacromialis) - is 12 cm. The circumference of the shoulder girdle is 35 cm.
2. Transverse size of the buttocks(diameter bisiliacalis) is 9-9.5 cm. Circumference 28 cm.
Lecture number 4. Signs of fetal maturity, the size of the head and body of a mature fetus
The length (height) of a mature full-term newborn ranges from 46 to 52 cm or more, averaging 50 cm. Fluctuations in the body weight of a newborn can be very significant, but the lower limit for a full-term fetus is 2500-2600 g. The average body weight of a mature full-term newborn 3400–3500 g. In addition to body weight and length of the fetus, its maturity is also judged by other signs. A mature full-term newborn has a well-developed subcutaneous fat layer; skin pink, elastic; the vellus cover is not pronounced, the length of the hair on the head reaches 2 cm; ear and nasal cartilages are elastic; nails are dense, protruding beyond the edges of the fingers. umbilical ring is located in the middle of the distance between the bosom and the xiphoid process. In boys, the testicles are descended into the scrotum. In girls, the small labia are covered with large ones. The cry of a child is loud. Muscle tone and movements of sufficient strength. The sucking reflex is well expressed.
The head of a mature fetus has a number of features. It is the largest and densest part of it, as a result of which it experiences the greatest difficulty in passing through the birth canal. After the birth of the head, the birth canal is usually sufficiently well prepared to advance the trunk and limbs of the fetus. The facial part of the skull is relatively small, and its bones are firmly connected. The main feature of the cranial part of the head is that its bones are connected by fibrous membranes - sutures. In the area of the suture connection there are fontanelles - wide areas of connective tissue. The absence of a strong connection between the bones of the skull has great importance during childbirth. A large head can change its shape and volume, as the sutures and fontanelles allow the bones of the skull to overlap each other. Due to this plasticity, the head adapts to the mother's birth canal. The most important sutures connecting the bones of the fetal skull are the following: the sagittal suture, passing between the two parietal bones; frontal suture - between two frontal bones; coronal suture - between the frontal and parietal bone; lambdoid (occipital) suture - between the occipital and parietal bones. Among the fontanelles on the head of the fetus, large and small fontanelles are of practical importance. The large (anterior) fontanel is diamond-shaped and is located at the junction of the sagittal, frontal, and coronal sutures. The small (posterior) fontanelle has a triangular shape and is a small depression in which the sagittal and lambdoid sutures meet.
Head full-term mature fetus has the following dimensions:
1) direct size (from the bridge of the nose to the occiput) - 12 cm, head circumference in direct size - 34 cm;
2) large oblique size (from the chin to the occiput) - 13–13.5 cm; head circumference - 38–42 cm;
3) small oblique size (from the suboccipital fossa to the anterior angle of the large fontanel) - 9.5 cm, head circumference - 32 cm;
4) average oblique size (from the suboccipital fossa to the border of the scalp of the forehead) - 10 cm; head circumference - 33 cm;
5) sheer, or vertical, size (from the top of the crown to the sublingual region) - 9.5-10 cm, head circumference - 32 cm;
6) large transverse dimension (the largest distance between the parietal tubercles) - 9.5 cm;
7) small transverse dimension (distance between the most distant points of the coronal suture) - 8 cm.
Dimensions torso fruit are as follows:
1) the size of the shoulders (diameter of the shoulder girdle) - 12 cm, the circumference of the shoulder girdle - 35 cm;
2) the transverse size of the buttocks is 9 cm, the circumference is 28 cm.
Reasons for measuring / examining the head:
1. The head first passes through the birth canal, making a series of successive movements.
2. Yavl. voluminous and most dense part.
3. The fontanels, which are clearly palpable during childbirth, make it possible to clarify the nature of the insertion of the head in the small pelvis.
4. The ability of the head to compress in one direction and in the other depends on the degree of density of the bones of the skull and their mobility.
the head of the fetus is bean-shaped. It consists of 2 parts: the face and the brain (volumetric) part. Skull - consists of 7 bones connected by sutures.
SEAMS: 1. Frontal - between 2 frontal bones. 2. Sagittate - between 2 parietal bones. 3. Lambdavid - between both parietal and occipital bones. 4. Coronal - between both parietal and frontal bones.
FELLOWS: fibrous plates at the junction of the sutures. The main ones are:
1. Large (front) - between rear parts both frontal and anterior parts of both parietal. Represents a comp. mk. plate, in the form of a rhombus (3O3 cm). Intersection of 3 seams: 1,2,4.
2. Small (rear) - has a f-mu tr-ka. Between the posterior parts of both parietal and occipital bones.
Large and small fontanel conn. arrow seam.
3. Lateral (minor): anterolateral, posterolateral.
7 head sizes: 1) Straight - S from the bridge of the nose to the occiput. L=12 cm, d=34–35 cm.
2) Large oblique - S from the chin to the most distant point of the back of the head. L=13.5 cm, d=39–41 cm.
3) Small oblique - S from the suboccipital fossa to the middle of the large fontanel. L=9.5 cm, d=32 cm.
4) Middle oblique - S from the suboccipital fossa to the anterior corner of the large fontanel (scalp). L=10 cm, d=33 cm.
5) Large transverse - S between the most distant points of the parietal sutures. L=9.5 cm.
6) Small transverse - between the most distant points of the coronal suture. L = 8 cm.
7) Vertical (vertical) - S from the middle of the large fontanel to the hyoid bone. L=9 cm, d=32–34 cm.
Pelvis from an obstetric point of view
Taz: The female pelvis is wider and shorter, wings ilium deployed to the sides, the entrance to the small pelvis has the shape of a transverse oval, the shape of the cavity of the small pelvis is cylindrical, the angle between the lower branches pubic bones blunt or straight.
In obstetric practice, the small pelvis is divided into 4 sections by conditional planes, which fan-shaped diverge from the pubic symphysis to the sacrum. IN clinical practice the following sizes are most commonly used female pelvis: distantia spinarum - the distance between the anterior superior iliac spines is 25–26 cm; distantia cristarum - the distance between the iliac crests is 28–29 cm; distantia trochanterica - the distance between big skewers, equal to 30–31 cm; true, or obstetric, conjugate - the distance between the posterior edge of the pubic symphysis and the cape is 11 cm. To determine the obstetric conjugate, it is necessary to subtract 9 cm from the outer straight size equal to 20–21 cm - a distance equal to the thickness of the tissues and the spinal column.
Normal sizes pelvis. Determining the truth of a conjugate
Full external pelvis measurement:
1. Distantia spinarum is the distance between the two anterior superior iliac spines (in N = 25 - 26 cm)
2. Distantia cristarum is the distance between the most distant points of the ridges (in N = 28 - 29 cm)
3. Distantia trochanterica is the distance between two skewers (in N = 30 - 31 cm)
4.Conjugata externa is the distance between the anterior top pubic articulation and supra-sacral fossa (in N = 20 - 21 cm)
If all 4 sizes are in N, you can deliver through the natural birth canal.
5. Conjugata diagonalis - S from the lower edge of the promontory to the symphysis (in N = 13 cm).
6. Conjugata vera - to determine it - 9 cm is subtracted from Conjugata externa (N = 20–9 = 11 cm).
7. Soloviev index - wrist circumference (in N = 13 - 18 cm). If the Solovyov index is less than 16 cm, then the bones of the skeleton are considered thin and Conjugata vera = Conjugata diagonalis - 1.5 cm. If the Solovyov index is 16 cm or more, then the capacity of the pelvis will be less (Conjugata vera = Conjugata diagonalis - 2 cm).
8. Lateral Kerner conjugate is the distance between the anterior superior and posterior superior spines of the same side (in N = 15 cm)
9. The height of the womb - in N = 5 cm
10. The height of the pelvis - the distance between the ischial tubercle and the pubic tubercle (in N = 9 cm)
11. Rhombus of Michaelis is a rhombus, the tops of which are points: on top - the supra-sacral fossa, below - the upper edge of the gluteal fold, from the sides - the posterior superior iliac spines. Vertical dimension - 11 cm. Transverse dimension (Tridandani distance) - 10 cm.
12. The circumference of the pelvis - the circumference of the hips in non-pregnant state(in N not less than 85 cm).
Objective methods for assessing fetal viability
periods of fetal viability. From 28 to 37 weeks - the antenatal period - the period of the life of the fetus during pregnancy.
The intranatal period is the period of life of the fetus in childbirth.
postnatal period divided by:
Early - neonatal (first 7 days)
Late - up to a month of life.
Childbirth. Premature - occur from 28 to 37 weeks inclusive.
Term delivery- 37 - 42 weeks.
Late delivery - 43 or more weeks.
New criteria for live birth.
· Gestational age 22 - 27 weeks.
Fruit weight 500 - 1000 g.
Fruit length - 25 cm or more.
· There is one of the signs: "heartbeat", "spontaneous breathing", "reflexes", "pulsation of the umbilical cord".
If lived 7 days of life.
Assessment Methods: 1) Non-invasive: determination of the level of α-fetoprotein. The study is carried out at 15–18 weeks. The level of fetoprotein in malformations, pathological. course of pregnancy.
Ultrasound - 3 times - first visit ♀ - pregnancy diagnostics. 2 - at 16-
18 weeks assessment of growth rates, detection of anomalies in development. 3 - 32-35 weeks. - condition, growth rate, term, articulation, weight of the fetus.
CTG, hysterography - continuous. at the same time register of fetal heart rate and uterine tone.
2) Invasive: amniocentesis - puncture amniotic fluid. The goal is cultivation, karyotyping. Chorionic biopsy - performed for karyotyping. Cordocentesis is the puncture of the vessels of the umbilical cord of the fetus in order to obtain its blood.
Hormonal function placenta
Placenta (P.) - " children's place, iron internal secretion, cat. combines func. ♀and fetus systems. By the end of pregnancy, M = 500 gr., d = 15–18 cm. In the placenta, a child's place, the maternal side, and the fruit side are distinguished. Pl. - lobular organ (50–70 lobules). Functions: gas exchange, endocrine function, protective, excretory. maternal and fetus. the bloodstream do not communicate with each other.
Hormonal function: Pl. together with the fetus image. single endocrine system(fetoplacental system). In Pl. impl. etc. synthesis, secretion, transformation of hormones of protein and steroid nature. Hormone production occurs in the trophoblast syncytium, the decidual tissue. Hormones Pl.:
- placental lactogen (PL) - is synthesized only in the placenta, enters the mother's blood, maintains placental function.
– chorionic gonadotropin(CG) - synthesized by the placenta, enters the mother's blood, participates in the mechanisms of fetal sex differentiation.
- prolactin - synthesis. placenta and decidual TC. – plays a role in the image and surfactant.
From cholesterol, containing. in the mother's blood, in the placenta image. pregnenolone and progesterone. Steroid hormones also include estrogens (estradiol, estrone, estriol). They cause hyperplasia and hypertrophy of the endometrium and myometrium.
In addition to these, Pl. capable of producing testosterone, CS, thyroxine, parathyroid hormone, calcitonin, serotonin, etc.
Intrapartum fetal protection
The impact of childbirth on the condition of the fetus: the fetus experiences an increasing e. hypoxia, hypercapnia, acidosis. Escort fight. decrease in uterine hemodynamics. Complicated birth act exacerbates intrauterine hypoxia. During childbirth, the condition of the fetus worsens in parallel with the pharmacological load, and some of the pr-you turned out. not direct toxic. d-e, but indirect.
The value of the position of the body of the woman in labor: the position of the pregnant woman. presented on the back. add. load on the CCC, and breathe. woman's system. For the outcome of childbirth and the condition of the fetus, and then for n / r. The position of the mother is of no small importance. The most physiological in time an attempt - a half-sitting or sitting position, as well as a position on the side. Childbirth in horizontal. position and more often accompanied. traumatization of the fetus and greater physiological. blood loss.
Operative delivery: All operations are charact. traumatic for the fetus. At the same time, they help ↓ perinatal mortality. Imposition of A. forceps - can lead to birth trauma n / r. C-section- allows n. ↓ perinatal mortality. Crucial has the timeliness of the operation, when it is possible to avoid prolonged labor, a long anhydrous period and the onset of fetal hypoxia. Bad influence Wrongly chosen anesthesia, technical errors can affect the fetus.
Features of care: after removal from the uterus, the child is made a normal circle resuscitation, aerosol therapy is prescribed, often respiratory stimulants. and heart. activities. The frequency of complications reaches 10.9% (operation during childbirth) and 1.7% (planned). The prognosis depends on the nature of A. pathology. The prognosis improves if the operation was performed in a planned manner.
Birth trauma: distinguish between birth trauma, birth injury and obstetric trauma. The first arose. under d-em physical. loads, properties. complication childbirth. The latter more often arose more easily where there is an unfavorable background in the womb. development, aggravated by hypoxia in childbirth. For acute or chronic zab-yah ♀, poisoning, pathological. during pregnancy, polyhydramnios, multiple pregnancy, overmaturity / prematurity, rapid / prolonged labor conditions are created for the occurrence of birth trauma.
Causes of intrauterine hypoxia and fetal death in childbirth: There are acute and chronic. fetal hypoxia: Chronic - 1. Maternal obstruction (decompensated heart defects, diabetes, anemia, bronchopulmonary pathology, intoxication, info). 2. Complications of pregnancy: late preeclampsia, overdose, polyhydramnios. 3. Zab-I fetus: hemolytic. disease, generalizations. IUI, malformations.
Acute - 1. Inadequate blood perfusion to the fetus from the maternal part of the placenta. 2. Detachment of the placenta. 3. Clamping of the umbilical cord. 4. Inability to tolerate changes in oxygenation, connection. with uterine contractions.
Causes of fetal death in childbirth: 1. Fetal asphyxia. 2. Hemolytic disease. 2. birth trauma. 3. VUI. 4. Malformations of the fetus.
18. Perinatology, definitions, tasks
Perinatology (antenatal p. - p. from 28 weeks before the onset of regular labor; intranatal - childbirth; postnatal - 7 days after birth). Tasks: 1. Prevention of pathology in childbirth.
2. Prevention of malformations.
3. Diagnosis of malformations.
4. Diagnosis and treatment of fetal distress.
The fetal skull consists of 2 frontal, 2 parietal, 2 temporal bones, occipital, sphenoid, ethmoid bone.
In obstetrics, sutures matter:
1) swept (sagittal); connects the right and left parietal bones, in front passes into large fontanelle , behind - in small ;
2) forehead seam; connects the frontal bones;
3) coronal seam; connects the frontal bones with the parietal.
3) occipital (lambdoid) suture; connects the occipital bone with the parietal.
The large fontanel has a diamond shape.
Small - a small depression at the junction of the sagittal and occipital sutures, triangular in shape. It is very important to distinguish fontanelles during palpation. 4 seams converge in BR, 3 seams converge in MP.
Thanks to the sutures and fontanelles, the bones of the skull in the fetus can move and go behind each other. The plasticity of the fetal head plays important role with various difficulties to advance in the MT.
Fetal head dimensions: each variant of presentation and the moment of the mechanism of childbirth corresponds to a certain size of the fetal head, with which it passes through the birth canal.
!1)Small oblique- from the suboccipital fossa to the anterior angle BR = 9.5 cm. OG with him 32 cm
2) Medium oblique- from the suboccipital fossa to the scalp of the forehead = 10.5 cm. OG = 33 cm
!3) Big oblique- from the chin to the farthest point of the back of the head = 13.5 cm. OG = 40 cm
4) Straight- from the bridge of the nose to the occiput = 12 cm OG- 34 cm
5) Vertical- from the apex of the temenma to the hyoid bone = 9.5 cm. OG = 32 cm.
6) Large transverse- the greatest distance between the parietal tubercles - 9.5 cm.
7)Small transverse- distance m\du the most distant points of the coronal suture - 8 cm.
Also, divide G by big And small segments.
BS is the largest circle with which it passes through the MT planes. MS - any diameter that is less than a large one. On the body of the fetus, the following sizes are distinguished:
The transverse size of the shoulder in = 12 cm, around the circumference 35 cm;
The transverse size of the buttocks = 9-9.5 cm, around the circumference 27-28 cm. Articulation of the fetus - the ratio of its limbs and head to the body. In normal articulation, the body is bent, the head is tilted towards chest, legs bent at the hip and knee joints and pressed to the stomach, the arms are crossed on the chest. The fruit is ovoid shaped.
Fetal position - the ratio of the longitudinal axis of the fetus to the longitudinal axis of the uterus.
1) longitudinal;
2) transverse;
3) oblique;
Fetal position - the ratio of the back of the fetus to the right or left side of the uterus. There are 1 and 2 positions. At 1, the back is turned to the left side of the uterus, at 2 - to the right.
Position type - the ratio of the back of the fetus to the anterior or back wall uterus. If the back is turned forward, they talk about the front view of the position, if backward - about the rear view.
Fetal presentation - the ratio of a large part of the fetus (head or buttocks) to the entrance to the MT. In the transverse and oblique positions of the fetus, the position is determined not by the back, but by the head: the head on the left - 1 position, on the right - 2.
presenting part - the lowest part of the fetus, which first passes through the birth canal.
head presentation it can be occipital, anterior head, frontal, facial.
breech presentation: pure gluteal (incomplete), mixed gluteal-leg (complete) and foot.
Date added: 2016-06-06 | Views: 717 |
