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THE FETUS:
FETAL SKULL AND ITS
SIGNIFICANCE IN LABOUR
ROZIAH ARABI
Module Coordinator
FFFM5024 MODULE 2: INTRAPARTUM
ADVANCED DIPLOMA IN MIDWIFERY 2014/2015
LEARNING OUTCOMES
At the end of this topic, students will be able to:
1. Describe the regions of the fetal skull
2. Describe the bones that make up the vault of
the fetal skull
3. Describe the sutures and fontanelles
4. Describe the various diameters of the fetal
skull and their significance in labour
1.
2.
3.
membranous tissue as
early as 8th weeks in-utero
Protects the most vital
organ of the body
Composed of:
The base
The face
The vault
The base
The bones
Vault are made up of :
2 frontal bones
2 parietal bones
2 temporal bones
1 occipital bone
ears
The sutures
Sutures are membranous junction between 2 bones
Important because they allow the bones to overlap
Thus reducing the size of the fetal skull and facilitating
delivery
The fontanelles
Fontanelles are membraneous spaces where
are important
1. Anterior fontanelle (in front of the vault)
2. Posterior fontanelle (at the back of the vault)
The fontanelles
The anterior fontanelle
Known as the Bregma
large diamond shaped space
At the junction of 4 sutures; the
The 4 regions
Is important because its often referred to in
obstetrics
A midwife should remember these regions
Besides knowing the regions, the attitude of
the fetal skull also a vital
Attitude means the relation of the fetal parts
head, spine and limbs to each other in this
case to fetal skull
ATTITUDE
The fetal head is capable of a wide range of movements:
1. Well Flexion
2. Extension
4. Rotation
DIAMETERS
The presenting diameters of the fetal skull are
Antero-posterior diameter
(engaging diameter)
Length in cm
1.
Sub-occipito bregmatic
9.5
1.
Occipito-frontal
11.5
1.
Face
Submento-bregmatic
9.5
1.
Brow
Mentor-vertical
13.5
= suboccipitofrontal
10.0 cm
OF
= occipitofrontal
11.5 cm
MV
= mentovertical
13.5 cm
SMV = submentovertical
11.5 cm
SMB = submentobregmatic
9.5 cm
The descriptions
SOB
The descriptions
MV
CIRCUMFERENCE
The important of knowing about the cephalic
learn are:
1. Biparietal
It measures 9.5 cm
2. Bitemporal
It measures 8.5 cm
The engaging diameters varies in
length, the shorter diameter are
Vertex presentation
Well flexed head
1.
When the head is well flexed, the sub-occipitobregmatic and the biparietal are the 2 diameters of
the presenting circular area and the circumference is
29 cm
Deflexed head
2.
Brow presentation
When partial extension occurs, the engaging
Attitude of head
1. Well flexed
2. Deflexed
3. Partial Eextension
29 cm
Shape of
circumference
Round
34.5 cm
Ovoid
38 cm
Round
circumference
Significant to labour:
The girdle of contact between the fetal skull
2. Deflexion
Significant to labour:
The girdle of contact between the fetal skull and
3. Extension
4. Partial extension
Bear in mind!
Attitude
Significance to delivery
1. Complete flexion
Normal labour
2. Deflexion
Prolonged labour
3. Extension
Prolonged labour
4. Partial Extension
Obstructed labour
Conclusion
Having a good knowledge about the fetal
skull is very important as this will help
you to identify the presentation, the
position of the fetal head and the
diameter that is distending the vagina
so that you could conduct the delivery of
the baby with minimal trauma to the
mother and baby.
Keywords to remember!
1. Presentation
2. Position
3. Engaging diameter
4. Girdle of contact
5. Stimulation
6. Uterine contraction
7. Type of labour and delivery
Thats all.