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Cardinal Movements

There are 8 cardinal movements of the head in normal labour.

  • Every – Engagement (synclitic or asynclitic)
  • Decent - Descent
  • Female - Flexion
  • I - Internal rotation
  • Choose to - Crowning
  • Employ - Extension
  • Rises - Restitution
  • Extremely - External rotation

Mnemonic: Every decent Female I choose to Employ Rises Extremely.

 

Engagement can be:

 

Synclitic

Asynclitic

 

When sagittal suture of the head of fetus lies in the transverse diameter of pelvic inlet (midway between the pubic symphysis and the sacral promontory)

It occurs in 25% cases

 

Anterior:

Sagittal suture is defected towards sacral promontory. Also k/a anterior parietal presentaion/Naegeles

obliquity. It occurs commonly in multipara

 

Posterior:

Sagittal suture is defected towards pubic symphysis, the posterior parietal bone thus becomes the leading part.

Also k/a Litzman obliquity/ parietal presentation

It occurs commonly in nulliparous

women.

 

Causes of non-engagement of head in a nullipara at term:

  • Malpresentatlons? I Occipitoposterior postition/deflexed head
  • Cephalopelvic disproportion?
  • Placenta previa? / Tumours in the lower seqrnent?
  • Tumours of the fetal neckQ /Cord around the neckQJHydrocephalusQ
  • Polyhydramnios?
  • Distended bladder and rectum.?





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