Maternity Nursing: Intrapartum Q 27
A laboring client complains of low back pain. The nurse replies that this pain occurs most when the position of the fetus is:
A. Breech
B. Transverse
C. Occiput anterior
D. Occiput posterior
Correct Answer: D. Occiput posterior
A persistent occiput posterior position causes intense back pain because of fetal compression of the sacral nerves. Occiput anterior is the most common fetal position and does not cause back pain.
Option A: Breech presentation is defined as a fetus in a longitudinal lie with the buttocks or feet closest to the cervix. This occurs in 3-4% of all deliveries. The percentage of breech deliveries decreases with advancing gestational age from 22-25% of births prior to 28 weeks’ gestation to 7-15% of births at 32 weeks’ gestation to 3-4% of births at term.
Option B: The transverse lie position is where the baby’s head is on one side of the mother’s body and the feet on the other, rather than having the head close to the cervix or close to the heart. The baby can also be slightly at an angle, but still more sideways, than up or down.
Option C: The left occiput anterior (LOA) position is the most common in labor. In this position, the baby’s head is slightly off-center in the pelvis with the back of the head toward the mother’s left thigh.