![]() It also gives an overview of the normal progression of Labour and the evolution from the traditional model described by Friedman to the contemporary partogram, influenced by the pioneering work of Zhang et al, according to which more time can be given to the labouring woman to achieve natural childbirth, provide maternal and foetal condition remains good. This chapter describes the Mechanism of Labour - the positional changes in the presenting part of the foetus to achieve a successful passage through the birth canal - with a brief look at the passenger (the foetus), the passage (the pelvis) and the powers (the uterine activity) and the complex interaction between them, resulting in the six cardinal movements – descent, flexion, internal rotation, extension, restitution and external rotation. It involves a complex interaction of uterine activity, the foetus and the maternal pelvis, to achieve a successful negotiation of this start of the human life. All rights reserved.Labour and delivery, the process by which the mature foetus is expelled from the uterus, is not a passive process. The information gathered by clinical examination and ultrasound should be integrated into clinical decision making.Ĭardinal movements fetal attitude fetal descent fetal position mechanics of labor ultrasound.Ĭopyright © 2021 The Authors. Ultrasound offers a historically unique opportunity for noninvasive, dynamic studies of the mechanics of labor. We would argue that descent is the main purpose of the uterine powers and cardinal movements, a description of the rotational movements the fetal head and shoulders must perform to obtain descent. German and older English literature lists only 4 rotational movements as the cardinal movements and excludes engagement, descent, and expulsion. Anglo-American literature lists 7 cardinal movements, namely engagement, descent, flexion, internal rotation, extension, external rotation, and expulsion. ![]() ![]() The fetus negotiates the birth canal and rotational movements are necessary for descent. Electronic address: mechanics of labor describe the forces required for fetal descent, and the movements that the fetus must perform to overcome the resistance met by the maternal bony pelvis and soft tissue. Olavs Hospital, Trondheim University Hospital, Trondheim, Norway (Drs Kahrs and Eggebø) Department of Clinical and Molecular Medicine, Faculty of Medicine and Health Sciences, Norwegian University of Science and Technology, Trondheim, Norway (Drs Kahrs and Eggebø) Department of Obstetrics and Gynecology, Stavanger University Hospital, Stavanger, Norway (Dr Eggebø). 3 National Center for Fetal Medicine, Department of Obstetrics and Gynecology, St.Olavs Hospital, Trondheim University Hospital, Trondheim, Norway (Drs Kahrs and Eggebø) Department of Clinical and Molecular Medicine, Faculty of Medicine and Health Sciences, Norwegian University of Science and Technology, Trondheim, Norway (Drs Kahrs and Eggebø). 2 National Center for Fetal Medicine, Department of Obstetrics and Gynecology, St.1 Department of Obstetrics and Gynaecology, Oslo University Hospital, Oslo, Norway (Dr Iversen) Institute of Clinical Medicine, University of Oslo, Oslo, Norway (Dr Iversen).
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