The critical distance to keep in mind is a. This distance corresponds with the true conjugate and is approximately 11 cm ( Figure 131-1A). The third stage ends with delivery of the placenta. The second stage is the pushing stage, which ends with the birth of the baby. The first stage starts with true labor contractions and ends when the cervix is completely effaced and dilated. The obstetric conjugate is the distance from the sacral promontory to a point on the inner surface of the pubic symphysis that is a few millimeters from the upper margin of the pubic symphysis ( Figure 131-1A). CARDINAL MOVEMENTS OF LABOUR 3 Cardinal Movements of Labour Head is floating Engagement BPD enters pelvic inlet Leading edge of the spine is at or below station 0 Descent Flexion Internal rotation Crowning Extension (delivers head) External rotation (restitution) Expulsion Delivery of anterior and posterior shoulders Cunningh. Alright, as a quick recap, labor is composed of 3 stages. This distance represents the smallest diameter of the inlet and is normally 11 cm or more ( Figure 131-1A). The presentation can roughly be divided into the following classifications: cephalic, breech, shoulder, and compound. The true conjugate can be estimated by subtracting 1.5 to 2 cm from the diagonal conjugate. The term presentation describes the leading part of the fetus or the anatomical structure closest to the maternal pelvic inlet during labor. However, this measurement cannot be made clinically. The true conjugate, a radiographic measurement of the pelvic inlet, is the distance from the sacral promontory to the superior aspect of the pubic symphysis ( Figure 131-1A). In order to maximize the patients chance at a vaginal delivery it is important to understand the basics of labor and delivery Stages of labor Mechanics of labor Cardinal movements of labor Delivery 27 How to effectively deliver a baby. To measure the diagonal conjugate place the tip of the middle finger at the sacral promontory and note the point on the hand that contacts the pubic symphysis ( Figure 131-1B). Cardinal Movements of Labor 26 Normal Labor and Delivery. A normal diagonal conjugate measures approximately 12.5 cm, with the critical distance being 10 cm. We would argue that descent is the main purpose of the uterine powers and cardinal movements, a description of the rotational movements the fetal head and shoulders must perform to obtain descent. The diagonal conjugate refers to the distance from the inferior border of the pubic symphysis to the sacral promontory ( Figure 131-1A). In Summary Know the different stages of labor Know the labor curve Know the cardinal movements of labor. There are 4, not 7, cardinal movements in labor Am J Obstet Gynecol MFM. Anglo-American literature lists 7 cardinal movements, namely engagement, descent, flexion, internal rotation, extension, external rotation, and expulsion.
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