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Normal Mechanism of Labour

SALSO COURSE
SARAWAK GENERAL HOSPITAL
Normal delivery
Pelvic inlet


               Pelvic outlet
Definition
   Mechanism of labour - the series of
    changes in position and attitude which the
    fetus undergoes during its passage through
    the birth canal
Normal mechanism of labour
               Descent
               Flexion
          Internal rotation
              Extension
             Restitution
          External rotation
          Delivery of body
             (DFI ERE)
Descent, flexion & internal rotation




 •Descent continues and occiput reaches pelvic floor
 •There is flexion of the head
 •Occiput now rotates to the front
 •Head is now in occiput-anterior
 •This is internal rotation
Crowning




•Occiput is now below symphysis pubis
•Further descent pushes the head forward with
 a movement of extension and the occiput is
 delivered
Extension - delivery of head




•Increasing extension around symphysis
 pubis delivers the bregma, brow and face
Restitution




 •Head rotates to natural position relative to the
  shoulders
 •This is restitution
External rotation




•Further descent and rotation causes the head to rotate so that the
 occiput lies to the left maternal thigh
•This is external rotation
•The anterior shoulder now slips under the symphysis pubis and
 with lateral flexion of the fetal body, the posterior shoulder is born
•The rest of the body follows easily
Normal Mechanism of Labour

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Normal Mechanism of Labour

  • 1. Normal Mechanism of Labour SALSO COURSE SARAWAK GENERAL HOSPITAL
  • 3. Pelvic inlet Pelvic outlet
  • 4. Definition  Mechanism of labour - the series of changes in position and attitude which the fetus undergoes during its passage through the birth canal
  • 5. Normal mechanism of labour Descent Flexion Internal rotation Extension Restitution External rotation Delivery of body (DFI ERE)
  • 6. Descent, flexion & internal rotation •Descent continues and occiput reaches pelvic floor •There is flexion of the head •Occiput now rotates to the front •Head is now in occiput-anterior •This is internal rotation
  • 7. Crowning •Occiput is now below symphysis pubis •Further descent pushes the head forward with a movement of extension and the occiput is delivered
  • 8. Extension - delivery of head •Increasing extension around symphysis pubis delivers the bregma, brow and face
  • 9. Restitution •Head rotates to natural position relative to the shoulders •This is restitution
  • 10. External rotation •Further descent and rotation causes the head to rotate so that the occiput lies to the left maternal thigh •This is external rotation •The anterior shoulder now slips under the symphysis pubis and with lateral flexion of the fetal body, the posterior shoulder is born •The rest of the body follows easily