A 24-year-old primigravida at 39 weeks gestation is completely dilated and actively pushing in the second stage of labor. The fetal head is descending through the maternal pelvis. To successfully navigate the pelvic structures, the fetus must undergo a series of specific positional changes. Arrange the following cardinal movements of labor in the correct chronological order from first to last.
- 1Engagement of the fetal presenting part
- 2Flexion of the fetal head
- 3Internal rotation of the fetal head
- 4Extension of the fetal head
- 5External rotation (restitution) of the fetal head
Answer
The correct chronological sequence is: Engagement, Flexion, Internal rotation, Extension, and finally External rotation.
The cardinal movements of labor (Every Darn Fool In Egypt Eats Raw Eggs: Engagement, Descent, Flexion, Internal rotation, Extension, External rotation, Expulsion) describe the necessary adaptations the fetus makes to navigate the maternal pelvis. The sequence begins with the head engaging in the pelvic inlet, followed by flexion to present a smaller diameter. As it descends further, it internally rotates to align with the anteroposterior diameter of the midpelvis. The head then extends to pass under the pubic symphysis and is born. Finally, the head externally rotates (restitution) to realign with the fetal shoulders for their subsequent delivery.
Step-by-Step Solution
Key Concept
Cardinal movements of normal labor
Estimated Time:45s