Published Dec 16, 2004
rn&momof3
4 Posts
Hello all. I would really appreciate your expertise on this. Can anyone tell me if they are familiar with an acynclitic fetal presentation? (I don't even know the correct spelling!). It has to do with a brow and posterior presentation resulting in symphysis pubis diastasis for mom. Thank you so much if you choose to help me out on this!
klone, MSN, RN
14,856 Posts
Asynclitic
Here's some info:
http://www.gentlebirth.org/archives/asnchead.html
http://www.gentlebirth.org/archives/position.html#Asynclitic
Edited to add: I dealt with this personally with my second child, who was born at home.
Dawn27
45 Posts
rn&momof3 i had not heard of this particular presentation until i saw your post and did a google search.
acynclitic - is the correct spelling or asynclitic it refers to the planes of the fetal head and the pelvis not being compatable
so brow or chin or ear presentation would all come under this heading. i am not sure diastasis has to occur, i got this definition
condition of parallelism between the planes of the foetal head and of the pelvis, respectively.
that was from dictionary.com
hope that helps a little.
So brow or chin or ear presentation would all come under this heading. I am not sure diastasis has to occur
Right, that was my understanding as well - it's basically the position of the head is cockeyed, which interferes with even pressure against the cervix, which can slow dilation.
Klone
I think you have summed it up perfectly
SmilingBluEyes
20,964 Posts
"cockeyed" is what comes to my mind, also.......NOT good and hardly ever succeeds at vag delivery.
When I delivered 9 months ago my nurse said the same thing after it was all over. I remember it exactly "wow you are amazing...in 16 years of practice I have never seen an -asynclitic, brow, posterior- delivery lady partslly". Well the fact is that I am not amazing...in order to delivery I suffered an extensive symphysis pubis diastasis. This was my third baby...my other two had relatively large heads and delivered within 4-5 hours with no complications. Although my membranes ruptured spontaneously at 8am (40 weeks) and I was having sufficient contractions for 5 hours the head was not decsending. The nurse artificially ruptured a remaining pocket of fluid (to get this over "before change of shift" and since the dr. had already had a "long day") and then things just got worse.The dr finally did a bedside US and determined the position (because I kept telling them something was WRONG!). Although the nurse and doctors shared this info about the position..they decided it best to just tell me ..good presentation...just need to push that baby out! The pain was so excruciating that I opted for an epidural (which I know now was the worst thing I could have done for a diastasis). My legs were pulled way back and I continued to push to exhaustion the entire time saying that something was not right. I finally opted to go to hand and knees in my delerious desparation. Nothing. After 12 hours of this I was petrified as I saw decels on the strip..and they applied O2. I was frantic I pushed like a mad woman (again just desparate to deliver). I asked that the Dr. come back in. I continued this way for another 2 hours untill "miraculously" he was delivered. Afterward, I heard the details about how they had the paperwork all prepared for C/S "for some time" and how they thought it best not to alarm me regarding his presentation. I was grateful that he was finally delivered but very concerned about his health and my own as I felt I had been "ripped apart"...seems that is just what happened. My babies head was terribly mangled and bruised. After delivery I could not walk without support. I would drag myself down the hall to his room using the railing. It was horrible and not to mention I had a 4 yr old, and a 22 mo old to take care of and no family or help around (of course my husband tried..but it was hard fo him to help when once he was back at work). An x-ray taken 1 week postpartum showed "significant" separation. I was told to wrap myself with an ace bandage and wait for at least 6 months to allow myself to heal. Since then I have suffered with continuous, unrelenting pain. Fortunately It has made everyday a srtuggle just to take care of my kids. I returned to the Dr. yesterday after 9 months and a repeat x-ray shows not only separation, but now one side is higher than the other...makes sense as I have the sensation that one leg is longer than the other and "things" are moving around. I delivered in a military hospital and I am concerned about the follow-up care (or lack thereof) I will receive. Phew! Probabaly much more than you cared to know! I would apprciate any feedback on this..how things could have been managed better during labor, if it is reasonable to let it go so long given I had delivered two large babies just 4 yrs and 22 months earlier relatively easily...and any ideas for the future management of diastasis. Thank you so much for taking the time on this!