Im revising at the mo and i have one equestion that im trying to work out what i would need to cover.

Has anyone ever done an assignment or revised for this type of question that cound help me? The question is

- with reference to appropriate anatomy and physiology how would the midwife recognise desent of the fetus during first stage?

How would people go about answering this question?

Any help would be so greatful.

__________________
Have you just been offered a place? If so and you want a mentor please post in post this forum (also post here if you would like a mentee)

As far as my limited knowledge goes, isn't it to do with how many 5ths are palpable?

If more than I think it's three 5ths palpable then it isn't engaged, it less than two 5ths are palpable then the head is considered to be engaged.

I am sure others will answer it better than me.

__________________
I'm in, thanks & bless you Mum & Dad x
Student Midwife 2007

Student uni rep
Educational Resources Manager

Have you just been offered a place? If so and you want a mentor please post in post this forum (also post here if you would like a mentee)

It would be descent felt through abdominal palpation.. 5ths palpable in relation to the pelvic brim.. As well as descent felt during vaginal examination... in relation to the ischial spines?
Would you include A&P of the pelvis, birth canal? pelvic floor? fetal skull perhaps? not to sure really.. just thinking allowed!

__________________
Duel X

2nd year student midwife

Yay, I wa partly right at least.

__________________
I'm in, thanks & bless you Mum & Dad x
Student Midwife 2007

Student uni rep
Educational Resources Manager

Have you just been offered a place? If so and you want a mentor please post in post this forum (also post here if you would like a mentee)

Thats what i was thinking. it just seems to include so much. I dont want to focus on the wrong parts.
Im not very clued up on descent felt during vaginal examination... in relation to the ischial spines. humm im going to have to do much more revision. Im off to the educational rescorces section, to see if they have any help.

__________________
Have you just been offered a place? If so and you want a mentor please post in post this forum (also post here if you would like a mentee)

Wishing you loads of luck Tink.

__________________
I'm in, thanks & bless you Mum & Dad x
Student Midwife 2007

Student uni rep
Educational Resources Manager

Have you just been offered a place? If so and you want a mentor please post in post this forum (also post here if you would like a mentee)

Yes it will be as the others said through descent I would imagine, so you could possibly put about palpation and determining, the position and lie, as well as presentation and station of the fetus. In relation to VE it may be in relation to ischial spines, if its -3 its doubtable unless you have long fingers that you could reach it, also where the cervix is i.e if you cannot touch/reach the cervix if its posterior etc.. so I imagine it will be descent in relation to position of cervix and ischial spines I always do it, that -3 not able to reach -2 is a stryggle to reach and difficult if cervix posterior, then not enough impact yet on cervix for it to be dilating at a reasonable rate (usually latent phase of labour) and the -1 I think is length of fingers without stretching, then at the spines is 1cm ish down your fingers etc... dunno if that makes sense its difficult to explain in typing!!
So I suppose you would have to start with palpation, position, lie and station, confirmed by examination, regular palpation and examination dependant on Trust policy, talk about the length of cervix, strength of contractions, I usually cover all bases just incase x

__________________


Have you just been offered a place? If so and you want a mentor please post in post this forum (also post here if you would like a mentee)

Thanks tracy that has really helped. Its put into a sequesnce that i can work throught.

I was going to message you, i have an email i have been sent about loads of study days coming up, wondered if you wanted them for the forum? If so where shall i forward my e mail. If not no probs.

__________________
Have you just been offered a place? If so and you want a mentor please post in post this forum (also post here if you would like a mentee)