![]() 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. Johanne Kolvik IVERSEN MD, Birgitte Heiberg KAHRS MD, PhD, T orbjørn Moe Eggebø MD, PhD. 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). There are four, not seven cardinal movements in labor. 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) Department of Obstetrics and Gynecology, Stavanger University Hospital, Stavanger, Norway (Dr Eggebø). The stage is usually about 2 hrs Most of the cardinal movements are done here May be prolonged due to sedation, epidural, persistent occiput posterior. 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). Mnemonic for cardinal stages of labor: Engagement Descent Flexion Internal Rotation Extension External rotation (Restitution). 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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