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Presentation of twins in Der Rosengarten ("The Rose Garden"), a standard medical text for midwives published in 1513.

In obstetrics, the presentation of a fetus about to be born refers to which anatomical part of the fetus is leading, that is, is closest to the pelvic inlet of the birth canal. According to the leading part, this is identified as a cephalic, breech, or shoulder presentation. A malpresentation is any presentation other than a vertex presentation (with the top of the head first).

Classification

Thus the various presentations are:

cephalic presentation (head first):
- vertex (crown) — the most common and associated with the fewest complications
- sinciput (forehead)
- brow (eyebrows)
- face
- chin
breech presentation^[1] (buttocks or feet first):
- complete breech
- footling breech
- frank breech
shoulder presentation:
- arm
- shoulder
- trunk

Related obstetrical terms

Attitude

Definition: Relationship of fetal head to spine:
- flexed, (this is the normal situation)
- neutral (“military”),
- extended.

Position

Definition: Relationship of presenting part to maternal pelvis: and based on presentation:Note fetus enters pelvis in occipito-transverse plane (left or right), descent and flexion then rotates 90 degrees to occipito-anterior (most commonly)
- Cephalic presentation
  - Vertex presentation with longitudinal lie:^[1]
    - Left occipitoanterior (LOA)—the occiput is close to the vagina (hence known as vertex presentation) faces anteriorly (forward with mother standing) and towards left. This is the most common position and lie.
    - Right occipitoanterior (ROA)—the occiput faces anteriorly and towards right. Less common than LOA, but not associated with labor complications.
    - Left occipitoposterior (LOP)—the occiput faces posteriorly (behind) and towards left.
    - Right occipitoposterior (ROP)—the occiput faces posteriorly and towards right.
    - Occipitoanterior —the occiput faces anteriorly (absolutely straight without any turning to any of the sides)
    - Occipitoposterior —the occiput faces posteriorly (absolutely straight without any turning to any of the sides)
  - Face presentation
- Breech presentation with longitudinal lie:^[1]
  - Left sacrum anterior (LSA)—the buttocks, as against the occiput of the vertex presentation, like close to the vagina (hence known as breech presentation), which like anteriorly and towards the left.
  - Right sacrum anterior (RSA)—the buttocks face anteriorly and towards the right.
  - Left sacrum posterior (LSP)—the buttocks face posteriorly and towards the left.
  - Right sacrum posterior (RSP)—the buttocks face posteriorly and towards right.
  - Sacrum anterior(SA)—the buttocks face anteriorly.
  - Sacrum posterior (SP)—the buttocks face posteriorly.
- Shoulder presentation with transverse lie are classified into four types, based on the location of the scapula (shoulderblade); note: this presentation needs to be delivered by cesarean section.
  - Left scapula-anterior (LSA)
  - Right scapula-anterior (RSA)
  - Left scapula-posterior (LSP)
  - Right scapula-posterior (RSP)

Lie

Definition: Relationship between the longitudinal axis of fetus and mother:
- longitudinal, (resulting in either cephalic or breech presentation)
- oskie, (cephalic presentation, fetus legs straight along frontal axis of mother)
- oblique, (unstable, will eventually become either transverse or longitudinal)
- transverse (resulting in shoulder presentation).

References

^ ^a ^b ^c Kish, Karen; Joseph V. Collea (2003). "Malpresentation & Cord Prolapse (Chapter 21)". In Alan H. DeCherney. Current Obstetric & Gynecologic Diagnosis & Treatment. Lauren Nathan (Ninth Edition ed.). Lange/McGraw-Hill. p. 369. ISBN 0-07-118207-1. |accessdate= requires |url= (help) CS1 maint: Extra text (link)

External links

Malpresentations and malpositions: A guide for midwives and doctors by the WHO
Normal Labor and Delivery from Management of Labor and Delivery provided by Google books

UpToDate Contents

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1. 分娩時の顔位および額位 face and brow presentations in labor
2. 横位の胎児 transverse fetal lie
3. Overview of issues related to breech presentation
4. 胎児の骨盤位分娩 delivery of the fetus in breech presentation
5. 筋腫（子宮筋腫）を有する女性における妊娠 pregnancy in women with uterine leiomyomas fibroids

English Journal

Risk factors for post-operative wound infection in the setting of chorioamnionitis and cesarean delivery.

Dotters-Katz SK1, Feldman C2, Puechl A3, Grotegut CA4, Heine RP4.
The journal of maternal-fetal & neonatal medicine : the official journal of the European Association of Perinatal Medicine, the Federation of Asia and Oceania Perinatal Societies, the International Society of Perinatal Obstetricians.J Matern Fetal Neonatal Med.2016 May;29(10):1541-5. doi: 10.3109/14767058.2015.1058773. Epub 2015 Jul 16.
OBJECTIVE: The objective of this study was to identify factors associated with an increased risk of post-operative wound infection in women with chorioamnionitis who undergo cesarean delivery.METHODS: We conducted a retrospective cohort study of women with clinical chorioamnionitis who underwent ces
PMID 26135793

Racial disparities in the optimal for induction of labor in low-risk term pregnancies: a national population-based study.

Vilchez G1, Dai J1, Gill N1, Lagos M1, Bahado-Singh R2, Sokol RJ1.
The journal of maternal-fetal & neonatal medicine : the official journal of the European Association of Perinatal Medicine, the Federation of Asia and Oceania Perinatal Societies, the International Society of Perinatal Obstetricians.J Matern Fetal Neonatal Med.2016 Apr;29(8):1279-82. doi: 10.3109/14767058.2015.1045865. Epub 2015 May 25.
OBJECTIVE: The recommendation for elective induction of labor (IOL) is to await ≥39 weeks. Studies show earlier maturity of Blacks compared to Whites. The objective was to examine the effect of the Black race on the risk of intrapartum and neonatal complications after IOL.METHODS: Black women with
PMID 26004983

Judicious use of oxytocin augmentation for the management of prolonged labor.

Rossen J1,2, Østborg TB3, Lindtjørn E3, Schulz J4, Eggebø TM3,5.
Acta obstetricia et gynecologica Scandinavica.Acta Obstet Gynecol Scand.2016 Mar;95(3):355-61. doi: 10.1111/aogs.12821. Epub 2015 Dec 8.
INTRODUCTION: A protocol including judicious use of oxytocin augmentation was investigated to determine whether it would change how oxytocin was used and eventually influence labor and fetal outcomes.MATERIAL AND METHODS: The population of this cohort study comprised 20 227 delivering women with sin
PMID 26576009

Japanese Journal

出血性ショックで発症し救命し得た新生児肝被膜下出血の早産超低出生体重児の一例

浅井洋子,五十嵐加弥乃,土田悦司,野原史勝,梶野真弓,高瀬雅史,白井勝,坂田宏,沖潤一
日本周産期・新生児医学会雑誌 = Journal of Japan Society of Perinatal and Neonatal Medicine 46(3), 842-847, 2010-08-30
NAID 10026707628

極低出生体重児の周産期因子と予後との関連

加藤恵美,山田秀人,花谷馨,松本憲則,服部司,藤本征一郎
日本産科婦人科學會雜誌 47(5), 465-472, 1995-05-01
直接的に児の予後と関連性をもつ可能性が高い母体合併症や IUGR又は大奇形などの症例を除いた極低出生体重児症例に対し, 周産期因子と児の予後 (新生児又は乳児死亡, major handicapの有無)との関連を検討することを本研究の目的とした. 今回われわれは, 上記の症例を除いた単胎の極低出生体重児128例 (在胎週数 (mean±SD) 27.1±2.0週, 出生体重 (mean±SD) 1 …
NAID 110002111269

骨盤位に対する灸療法の試み

丹羽邦明,金倉洋一,松原英孝,野村祐久,永田文隆,新里康尚,釜付弘志,森川重敏,米谷国男,徳永泰基
日本東洋醫學雜誌 45(2), 345-350, 1994-10-20
骨盤位妊娠に対し古くから胸膝位,外回転術などの胎位矯正術が試みられているがその確実性や安全性については疑問が残っている。そこで我々は三陰交,至陰と湧泉の経穴に灸療法を施行して骨盤位矯正を試みた。対象は,分娩まで観察管理可能であった22例,妊娠継続中で分娩に至っていない6例,計28例について検討した。頭位に矯正できたのは25例で矯正率89.3%だった。灸療法中および療法後に子宮収縮に伴う痛みなどの異 …
NAID 110004001086