Documenti di Didattica
Documenti di Professioni
Documenti di Cultura
Posterior Fetus
Oleh :
Wiliyanto. Wijaya
Pembimbing :
Dr. IMS Murah Manoe, SpOG (K)
Belly Mapping
Incidence of OP
Menurut penelitian :
Dextrorotation: like other natural objects, the human body
has a tendency to move in a clockwise direction
Muscular imbalance: psoas muscles and round ligaments
can be tighter on one side than the other, pulling the uterus to
one side
Posture: poor maternal posture and lack of forward movement
(e.g.housework) increase the risk
Morphology: short stature and short waistedness increase the
risk of posterior positioning
Placental location: increased incidence with anterior placental
sites
Clinical Concerns With OP
Longer labor
Maternal fatigue/discouragement
Increased need for psychological support
Transfer to hospital
Medical interventions
Surgical delivery
Traumatic birth for mother and/or baby
Post-Traumatic Stress Disorder?
What to Do: Determine Cause
for Prolonged Labor
Recognize reasons other than OP for prolonged
labor:
Persistent asynclitism/OT (fetal dystocia)?
Inadequate contractions (uterine dystocia)?
Emotional dystocia?
Cervical dystocia?
Pelvic dystocia?
Iatrogenic dystocia?
Diagnosis POPP
1. Sutura sagitalis terbalik di dalam Pelvis
2. Fontanella anterior ke arah simfisis
3. Bunyi jantung Terkeras jauh di lateral.
4. Kapus suksedaneum pada bagian
belakang kepala :
* Di kanan pada oksiput posterior kiri
* Di kiri dalam oksiput posterior kanan.
Know the basic term fetal head diameters
Depending on the presentation, the fetal head will deliver easily, as in occiput anterior
position, when the presenting diameter is 9.5 cm, or with difficulty, as when the presenting
diameter is 11.5 cm or more.
Mekanisme Persalinan
Kelainan defleksi
Derajat fleksi tertentu Tengkuk bayi
berada pada sakrum ibu, fontanella
posterior dan sutura sagitalis pada lantai
pelvis
Fontanella anterior fulkrum untuk fleksi
pada arkus subpubis
Kepala harus didefleksikan lebih lanjut pada pintu keluar pelvis
sampai oksiput berada di atas perineum.
Ilustrasi
What to Teach
Exaggerated
Lithotomy
(McRoberts)
Success!
Stitely & Gherman
Consider possible causePrimary
Physiologicalinterventions based on
Primary action
presumed cause Result No
OB interventions
Secondary action