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Mechanism of Normal Labour

The document describes the cardinal movements of labor, which are the passive movements that allow the fetus to descend through the birth canal during delivery. The key movements are descent, flexion, internal rotation of the head, crowning, extension of the head, restitution, internal rotation of the shoulders, external rotation of the head, and lateral flexion. Together these movements reduce the fetal diameter and allow different presenting parts to navigate the pelvis and birth canal for delivery.

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4K views

Mechanism of Normal Labour

The document describes the cardinal movements of labor, which are the passive movements that allow the fetus to descend through the birth canal during delivery. The key movements are descent, flexion, internal rotation of the head, crowning, extension of the head, restitution, internal rotation of the shoulders, external rotation of the head, and lateral flexion. Together these movements reduce the fetal diameter and allow different presenting parts to navigate the pelvis and birth canal for delivery.

Uploaded by

swethashaki
Copyright
© © All Rights Reserved
We take content rights seriously. If you suspect this is your content, claim it here.
Available Formats
Download as DOCX, PDF, TXT or read online on Scribd
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MECHANISM OF NORMAL LABOUR / CARDINAL MOVEMENTS OF LABOUR

DEFINITION
As the fetus descends, soft tissue and bony structures exert pressures which lead to
descent through the birth canal by a series of passive movements collectively these movements
are called as Mechanism of labor.

PRINCIPLES
 Descent takes place throughout the labor.
 Whichever part leads and first meets the resistance of the pelvic floor will rotate forwards
until it comes under the symphysis pubis.
 Whatever emerges from the pelvis will pivot around the pubic bone.

CHARECTERISTICS
 Lie is longitudinal
 Attitude is one of the good flexion
 Presentation is cephalic presentation
 Position is left occipito anterior
 Denominator is the occiput
 Presenting part is the posterior part of the anterior parietal bone
 Occiput points in right ileo pectineal eminence
 Sagittal sutures lies in right oblique diameter
 Presenting diameter is suboccipito frontal diameter 10cm
 Shoulders lies in left oblique diameter

MAIN MOVEMENTS

1) Descend:
 In primi gravida it occurs during latter weeks of pregnancy
 It will be aided by
 Forces of uterine contraction and retraction
 Rupture of fore waters
 Full cervical dilatation
 Maternal efforts speeds progress
 Slope of the pelvic floor muscle

2) Flexion:
 This increases throughout the labor
 Because of uterine contraction, fetal axis pressure will be exerted more on the occiput
than the sinciput causing good flexion
 Because of flexion the suboccipito frontal 10cm is reduced into suboccipito bregmatic
9.5cm
 The occiput is the leading part

3) Internal rotation of the head:


 Because of gutter – shaped and slope of pelvic floor gives resistance
 The slope of the pelvic floor determines the direction of rotation
 The second principle applied. The occiput is the leading part and meets the pelvic floor
resistance and it will rotate 1/8 of the circle forward until it comes under the symphysis
pubis.
 Because of internal rotation there is a twist at the neck.
 The sagital suture move from right or left oblique to Antero – posterior diameter
4) Crowning:
 The occiput slips beneath the sub-pubic arch and crowning take place
 The presenting part engages the vaginal outlet and it will not recede backward.
 The sub-occipito bregmatic diameter 9.5cm distends the vaginal outlet.

5) Extension of the head:


 Once crowning occur fetal head can extend
 Third principle applied
 The fetal head pivot around the the pubic bone
 This releases sinciput, face and chin sweeps the perineum and born by a movement of
extension.
 The suboccipito frontal diameter 10cm distends the vaginal outlet

6) Restitution:
 The occiput moves one-eighth of a circle towards the side from it started
 Because of this the twist in the neck of the fetus which resulted from internal rotation is
now corrected by a slight un twisted movement

7) Internal rotation of the shoulder:


 Now the shoulder is the leading part which meets the pelvic floor resistance
 Again second principle applied
 So from oblique diameter it will turn to Antero – posterior diameter

8) External rotation of the head:


 The head rotate in same direction as restitution and the occiput of the fetal head
now lies laterally

9) Lateral flexion:
 Anterior shoulder deliver by downwards and backward movement and posterior shoulder
deliver by upward and forward movement
 Body will be delivered by lateral flexion

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