Fetal Presentation Simulator in Obstetric Vaginal Exam
The diagnosis of labor is made based on the assessment of uterine dynamics and also on the examination of the obstetric vaginal touch examination, which is used to identify effacement, consistency and cervical dilation, the presence or absence of the amniotic sac, feeling its integrity or rupture, the height of the presentation, the variety of the position and the determination of the attitude from the maternal bony pelvis.
From this with all this information, the obstetric examination allows you to monitor the labor. Thus, it is important to train and perceive these characteristics and stages of the process, and the use of simulators for this preparation can be very useful.
The proposed models aim to help students and those interested in building this knowledge and practice.
Construction
Materials
1 doll
1 bony anatomical pelvis
Instructions
1. The fetal presentation refers to the part of the body of the fetus that comes out first, it can be normal, called cephalic, or abnormal face, forehead, pelvic and shoulders. In the cephalic, from the touch it is possible to feel the hard, rounded, non-compressible surface and also allows the analysis of the sutures and fontanelles to understand the baby’s position.
Position: is classified backwards (towards the mother’s back, i.e. facing downwards when the woman lies on her back), forwards (facing upwards), leftwards (back on the left of the maternal abdomen) and rightwards (back on the right of the maternal abdomen).
2. In addition, the fetal attitude or static is analyzed, which is the relationship of the fetus with its own axis, which becomes curved on itself according to its growth and accommodation inside the uterus.
Attitude: it is classified in relation to the anteroposterior axis (flexed and deflected) and laterolateral axis (Synclitism – sagittal suture at the same distance from the pubic symphysis and sacral promontory and Asynclitism – misaligned sagittal suture, with degrees of lateralization; posterior – closer to the pubis , anterior – closest to the sacrum).
3. Also, the height of the baby’s head is analyzed from the depth at which the fingers are placed or by the ‘De Lee Plans’ referenced from the maternal ischial spine, being the zero point. Palpation of the ischial spines is performed on the side of the vagina, from which transverse planes are delimited, which vary from -3 to +3, measured in cm, and the higher the number, the closer the birth.
Height: distance in cm in depth from the maternal ischial spine, can vary from -3 to +3.
What is expected is a cephalic presentation, facing backwards, face and body angled towards the right or left, neck curved forward, chin tucked in and arms folded over the chest.
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