Maternity Nursing Q 94

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During an internal examination, the nurse palpated the posterior fontanel to be at the left side of the mother at the upper quadrant. The interpretation is that the position of the fetus is:

  

     A. LOA

     B. ROP

     C. LOP

     D. ROA

    

    

Correct Answer: A. LOA

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The landmark used in determining fetal position is the posterior fontanel because this is the nearest to the occiput. So if the nurse palpated the occiput (O) at the left (L) side of the mother and at the upper/anterior (A) quadrant then the fetal position is LOA.

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Option B: In the right occiput posterior position (ROP), the baby is facing forward and slightly to the right (looking toward the mother’s left thigh). This presentation may slow labor and cause more pain.

Option C: When facing forward, the baby is in the occiput posterior position. If the baby is facing forward and slightly to the left (looking toward the mother’s right thigh) it is in the left occiput posterior (LOP) position. This presentation can lead to more back pain (sometimes referred to as “back labor”) and slow progression of labor.

Option D: The right occiput anterior (ROA) presentation is also common in labor. In this position, the back of the baby is slightly off center in the pelvis with the back of the head toward the mother’s right thigh. In general, OA positions do not lead to problems or additional pain during labor or birth.

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