![]() As hands move toward the pelvic brim, assess for the following: if the hands converge (come together) around the presenting part, it is floating if the hands diverge (move apart), the presenting part is either dipping or engaged in the pelvis. If the cephalic prominence is felt equally on both sides: military position (common in posterior position), or nonflexed. If the cephalic prominence is felt on the same side as the back: occiput (or crown), fetal vertex slightly extended. If the cephalic prominence is felt on the same side as the small parts: sinciput (fetus’ forehead), fetus vertex is flexed. The cardinal movements that occur during the mechanism of labor describe the movement of the fetus through the birth canal. The examiner presses deeply with the fingertips, toward the symphysis pubis, locating the cephalic prominence. ![]() 6 In cases of face presentation, a vaginal delivery can be accomplished most frequently with a mentum anterior position, but the mentum posterior position will impede the fifth cardinal movement of labor (extension). ![]() German and older English literature lists only 4 rotational movements as the cardinal movements and excludes engage-ment, descent, and expulsion. The incidence of face presentation has been quoted as 0.21 of all deliveries. The examiner places their hands on each side of the uterus, below the umbilicus and pointing toward the symphysis pubis. Anglo-American literature lists 7 cardinal movements, namely engagement, descent, flexion, internal rotation, extension, external rotation, and expulsion. In this maneuver, the examiner faces the woman’s feet. ![]() Fourth maneuver (fetal attitude and engagement) (see Figure 37-7D)-determines flexion or attitude of the fetal vertex or the greatest prominence of the fetal head over the pelvic brim. Cardinal Movements of Labor Aug 7 A baby’s position is important for birth to proceed naturally, allowing the smallest part of the baby to present first. ![]()
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