Flexion: Flexion occurs during descent.Descent: Descent occurs as the baby’s head moves deeper into the mother’s pelvic cavity.Engagement may occur toward the end of pregnancy or during labor. The entry point of the mother’s pelvis (pelvic inlet) has its widest diameter from right to left. Engagement: Engagement occurs when the widest part of the baby’s head (the biparietal diameter, measured from ear to ear) enters the mother’s pelvis.These movements work to allow the smallest diameter of the baby’s head to pass through the mother’s pelvis. The rest of the baby's body is then born, with an upward motion of the baby's body by the care provider.There are seven cardinal movements a baby makes while attempting to get into the best position for birth. The perineum becomes distended by the posterior shoulder, which is then also born. ■ Movement is brought on the same pelvic factors that produced internal rotationĪlmost immediately after external rotation, the anterior shoulder moves out from under the pubic bone (or symphisis pubis). ■ If occiput was originally directed right rotates towards R ischial tuberosity If occiput was originally directed left rotates towards L ischial tuberosity Occiput and fetal body rotate into transverse position rotates bisacromial diameter.Immediately after delivery of the head, the chin drops downwards to lie over maternal anus.Force from pelvic floor and pubic symphysis, acts anteriorly Force exerted by the uterus acting posteriorly. Due to resultant vector in the direction of introitus.After internal rotation is complete and the head passes through the pelvis at the nape of the neck, a rest occurs as the neck is under the pubic arch.(or head) rotates to the occipitoposterior position. If anterior rotation does not occur, the occiput So the baby must move from a sideways position to one where the sagittal suture is in the anteroposterior diameter of the outlet At the pelvic outlet, the diameter is widest from front to back. At the pelvic inlet, the diameter of the pelvis is widest from right to left. As the head reaches the pelvic floor, it typically rotates to accommodate for the change in diameters of the pelvis. Chin is brought towards the chest Shifts from longer occipitofrontal diameter (12cm) to shorter suboccipitobregmatic diameter (9.5cm).The smallest diameter of the baby's head (or suboccipitobregmatic plane) presents into the pelvis. The resistance brings about a flexion in the baby's head so that the chin meets the chest. This movement occurs during descent and is brought about by the resistance felt by the baby's head against the soft tissues of the pelvis.Extension and straightening of fetal body.Bearing-down of maternal abdominal muscles.Direct pressure on the breech by the fundus during contractions.Multiparas: descent usually begins with engagement.Nulliparas: descent occurs during 2nd stage.The baby's head becomes markedly molded when these distances are closely the same. The baby's head moves deep into the pelvic cavity and is commonly called lightening. Does not enter pelvis in direct OA or OP.Fetal head enters pelvis transversely (OT) or obliquely (ROA or LOA).
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