![]() ![]() 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. Quick overview: Mechanisms of labor - physiological changes in positioning that take place during normal vaginal delivery. 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. An article in this issue demonstrates the potential for using videos of birth to teach the cardinal movements of physiological breech birth in the upright position and the indications and techniques for maneuvers when needed. The examiner presses deeply with the fingertips, toward the symphysis pubis, locating the cephalic prominence. ![]() The examiner places their hands on each side of the uterus, below the umbilicus and pointing toward the symphysis pubis. ![]() In this maneuver, the examiner faces the woman’s feet. Learn about the 7 cardinal movements of labor: Engagement, Descent, Flexion, Internal Rotation, Extension, External Rotation and Expulsion cardinalmovements. 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. ![]()
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