Prednisolone previa

The biomechanism of labor. Usually labor at Prednisolonum previa flow in the rear (back of his head backwards, large anterior Fontanelle). It is extremely rare turn heads back to the front, and face backwards. This kind of biomechanism of labor leads to impossibility of spontaneous delivery.
The biomechanism of labor when Prednisolonum previa is that at the entrance to the pelvis swept seam can be installed as either the cross or in one of slanting size, with a large fontanel is wired point, small as spring is above, is falling behind in the progress and difficult to reach. In the pelvic cavity of internal rotation is done so that a large fontanel turns to fold (Fig. 85). The output of the pelvis head makes two movements: the first - flexion, which resulted from under the crotch exempt crown and nape; the second extension, which under the symphysis exempt frontal facial. The fixation points during the first move (bending) serves the area perenosa, at the second - suboccipital hole. The last moment - the outer turning the head and internal rotation of the hanger is made, as in the occipital previa. The greatest pressure Boulevard ring test, when the crown is set with its circumference, corresponding to direct the size of the head, running from the forehead to the nape of the neck (circumferentia frontooccipitalis - 34 cm).

Fig. 85. Prednisolone presentation. Head on the pelvic floor.

Fig. 86. Prednisolone presentation. The cutting head.

The biomechanism of labor when Prednisolonum previa often mixed with biomechanism of labor in the back of the form occipital presentation, notwithstanding the difference between them (see tab. "The main points of biomechanism of labor").
With front-view prednisolone previa the leading part of the region is a large fontanel, and a fixation point under the symphysis is the glabella, and in the tailbone - occipital bone (Fig. 86).
In the back of the form occipital presentation leading point is the back of the head (small fontanel), under the symphysis is set to a large fontanel or boundary of the scalp, forehead, and in the tailbone - suboccipital hole. The head is cut through by a circle, the corresponding average slanted amount equal to 10.5 cm (circle, corresponding to it, is 83 cm).
Thus, the distinction between ustawieniami head when Prednisolonum previa (rear view) and rear view occipital presentation is that when you first head is in the initial extent extension, and at the second able bending.
Labor at Prednisolonum previa is usually delayed. Very typical configuration head, which appears to be extended upwards, being compressed in the frontal-occipital size (tower skull) (Fig. 87). Frontal and occipital bones are mostly shifted under the parietal, front parietal bone comes on the back. Generic tumor is in the circle of big spring and mainly ahead at the half of the skull.

Fig. 87. Head of the newborn, who was born in Prednisolonum previa.

Recognition prednisolone presentation is possible only when vaginal examination, it is determined that the leading point of the head is large fontanel, tend to shift to the front. Not to be confused concepts prednisolone previa, in which the lowest point is the large fontanel, with prednisonum previa, which is determined by low located prednamerennoe bones and offset swept seam backwards (Cape).
The prediction depends not only on the characteristics of biomechanism of labor when Prednisolonum previa, but also on related complications (narrow pelvis, premature rupture of membranes, difficulties on the part of the soft parts and so on).
The tactics of the births in Prednisolonum previa should be waiting. You need to put a woman on the side where the head of the fetus, as it facilitates lowering the last.
Spontaneous births occur in 74%. The mortality rate of mothers is not more than occipital previa. Child mortality, according to some authors, when Prednisolonum previa three times more than the front as occipital presentation that explains the frequency of asphyxia with this type of presentation of the head, as well as more frequent use of rodorazreshajushchaja operations. All kinds of attempts to repair manual should be rejected, as hasty operational benefits. If you have to apply the tongs, the extraction head should try to reproduce the natural biomechanism of labor when Prednisolonum previa. The first traction produce down and up until glabella not fit under the pubic connection; then traction made up before the birth of the nape, and then arm fall down to derive from under the bosom of the face. Traction should be made easily and closely monitor the progress of the head, as it can easily get out of ancestral ways and cause serious injury to the vagina and perineum; therefore, when the dead fetus shows perforation head with subsequent kranichsee.