1. MECHANISM OF LABOUR

2. FETAL LIE
The relation of the long axis of the fetus to that of the mother
Longitudinal lie is found in 99% of labours at term
Predisposing factors for transverse lie/oblique lie
multiparity
placenta previa,
hydramnious
uterine anomalies

3. FETAL PRESENTATION
The presenting part is the portion of the body of the fetus that is foremost in the birth canal
The presenting part can be felt through the Cx on vaginal examination
Longitudinal lie  cephalic presentation
breech presentation
Transvrse lie  shoulder presentation

4. CEPHALIC PRESENTATION
Head is flexed sharply  vertex / occiput presentation
Head is extended sharply  face presentation
Partially flexed  bregma presenting (sinciput presentation)
Partially extended  brow presentation
BREECH PRESENTATION
Frank breech
Complete breech
Footling breech

5. ATTITUDE
Posture of the fetus folded on itself to accommodate the shape of the uterus
Flexed head, thighs, knees &feet
The arms crossed over the chest
Face presentation extended concave contour of the vertebral column

6. c (A) vertex (B) sinciput (C) brow (D) face I D .'" ' A B
! 1\ 11 A B ii F c
(A) vertex
(B) sinciput
(C) brow D
(D) face
Longitudinal lie. Ce­phalic presentation. Differences in attitude of fetal body,

7. Longitudinal lie. Frank breech presentation.
I I
Longitudinal lie. Frank breech presentation.
Longitudinal lie. Complete breech presentation.

8. Longitudinal lie. Incomplete, or footling, breech presentation.

9. POSITION
The relation of an arbitrary chosen point of the fetal presenting part to the Rt or Lt side of the maternal birth canal
The chosen point
Vertex presentation  occiput
Face presentation  mentum
Breech presentation Sacrum
Each presentation has two positions Rt or Lt
Each position has 3 varieties : Ant, transverse, post OA
ROA
LOA
ROT
LOT
ROP
LOP OP

10. LONGITUDINAL LIE VERTEX PRESENTATION
LOP
LOA ~
'tJ

11. Longtitudinal Lie.Vertex Presentation
A. Right occiput posterior (ROP)
Right occiput transverse (ROT) s A
Longtitudinal Lie.Vertex Presentation

12. (1 bJ 3~ al ta tb oj a ill Sf a! w Cc ht p( fit tb fe c
Right occiput anterior (ROA).
w Cc
ht p(
fit tb fe w c
al ta tb oj

13. Lt mento-ant Rt mento-ant Rt mento-post
Longitudinal lie. Face presentation. Left and right anterior and right posterior positions.

14. ~
Longitudinal lie Breech presentation LSP

15. Transverse lie. Right acromiodorsoposterior position (RADP)
Transverse lie. Right acromiodorsoposterior position (RADP). The shoulder of the fetus is to the mother's right, and the back is posterior.

16. Lever action producing FLEXION of the head; conversion from occipitofrontal to suboccipitobregmatic diameter typically reduces the anteroposterior diameter from nearly 12- to 9.5 cm.

17. Left lateral
Knee chest

18. Squatting
Standing

20. Types of episiotomy
Medio-lateral
Median
Lateral
J shaped 20

30. 2.Engagement;descent, flexion 6. Restitution (external rotation)
Cardinal movements in the mechanism of labor and delivery, left occiput anterior position.
302
2.Engagement;descent, flexion
6. Restitution (external rotation)
3. Further descent, internal rotation
4. Complete rotation, beginning extension

31. ,. ,0
Mechanism of labor for right occiput posterior position, anterior rotation.