A multigravida client at 38 weeks gestation is in active labor. During vaginal examination, the nurse palpates…

Question

A multigravida client at 38 weeks gestation is in active labor. During vaginal examination, the nurse palpates the fetal head at -1 station with the sagittal suture running anteroposteriorly and the posterior fontanelle easily palpated anteriorly. What fetal position does this assessment indicate?

Accepted Answer

보기 2: Left occiput anterior (LOA)

Sagittal suture anteroposterior and posterior fontanelle anterior indicate LOA position. Other positions would have different suture or fontanelle orientations.

Answer

보기 1: Right occiput anterior (ROA)

Answer

보기 3: Right occiput posterior (ROP)

Answer

보기 4: Left occiput posterior (LOP)

Term	Description	Clinical Significance
Fetal Lie	Relationship of fetal spine to maternal spine (Longitudinal, Transverse, Oblique).	Longitudinal lie is necessary for vaginal delivery.
Fetal Presentation	Part of fetus entering pelvic inlet first (Cephalic, Breech, Shoulder).	Vertex (cephalic) is most common and optimal.
Fetal Position	Relationship of presenting part to maternal pelvis (e.g., LOA, ROP).	Determines mechanics of labor; anterior positions are most favorable.
Station	Level of presenting part relative to ischial spines (-5 to +5).	-1 station means engagement has begun; head is 1 cm above spines.
Sagittal Suture	Membranous joint between the two parietal bones of fetal skull.	Key landmark for determining position during vaginal exam.
Fontanelles	Membranous gaps at intersection of sutures (Anterior & Posterior).	Posterior fontanelle (triangular) points toward occiput; Anterior (diamond) points toward brow.

Position	Occiput Location	Palpable Landmark Anteriorly	Suture Line Orientation	Labor Implications
LOA / ROA	Left/Right & Anterior	Posterior Fontanelle	Oblique or Anteroposterior	Favorable, efficient labor
LOP / ROP	Left/Right & Posterior	Anterior Fontanelle	Oblique or Anteroposterior	May cause "back labor," prolonged descent
LOT / ROT	Left/Right & Transverse	Sagittal Suture (transverse)	Transverse	Needs rotation to anterior for delivery

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A multigravida client at 38 weeks gestation is in active labor. During vaginal examination, the nurse palpates the fetal head at -1 station with the sagittal suture running anteroposteriorly and the posterior fontanelle easily palpated anteriorly. What fetal position does this assessment indicate?

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