(Mechanism of labor)

Presentation Vertex
Bregma

. Vertex Presentation . Bregma Presentation

1. Engagement
2. Flexion
3. Descent
4. Internal rotation
5. Extension
6. Restitution
7. External rotation
8. Expulsion
 Engagement ()

Engagement (Bilateral diameter)

( pelvic inlet)

Engagement

engagement
(lightening subcidence)

Engagement (A-P
dimeter)

.

. Promontary of sacrum

(sagittal suture)
Sacrum
Synclitism

sacrum Asynclitism
Anterior Asynclitism Naegele, s obliquity
sacrum
 Synclitism

Anterior Asynclitism (Naegele, s obliquity)

Posterior Asynclitism
,
Liztmann s obliquity

Posterior Asynclitism (Liztmann, s obliquity)

Engagement
Posterior asynclitism Synclitism Engagement Engagement
Anterior asynclitism Posterior
asynclitism

 . . Engagement . Engagement

Engagement Molding
molding
Membranous

occipital frontal parietal parietal

SOB, SOF, OF Biparietal
OM

molding ( molding , molding )

Molding molding
molding
molding


Engagement
1. (Lightening)
2.
Pawlik, s grip
Bilateral inquinal grip

3. station
Ischial spine Engage
 . Pawlik, s grip Bilateral inquinal grip

(Flexion)

Flexion (attitude)
( )
OF . . SOB . .

. Flexion . Complete Flexion

Flexion
1. Fetal axis pressure :

. :
sacrum
(Occiput anterior position) engagement


 fetal axis pressure

. :

. :
pelvic floor
Flexion pelvic floor


Complete flexion SOB
. .
OF

Flexion
. cephalic prominences

Flexion

.
Flexion

(Descent)

1. Fetal axis pressure
Occipito
vertebral
2.








3.

descent

 1.


2.

3.
Station -, + , +
4.
5.

(Internal rotation)
(Pelvic floor)
(Occiput
anterior position) (Sagittal suture) (A-P
diameter) ( )
(Persistant occiput posterior : OPP) (Transverse
arrest)

LOA internal rotation

Internal rotation LOA

-
 1. (LOA ROA)

2. (LOT ROT)
LOA ROA
OA
3. (LOP ROP)
LOT LOA OA
ROT ROA OA
Internal rotation
1. Pelvic floor Occiput
Pelvic floor ( )
2. Pelvic floor
3.
Oblique diameter Antero-posterior diameter
Coccyx . ( )

Pelvic floor

. . .

Internal rotation
Internal rotation
Engaged
-

(Extension)

Subocciput
SOB SOF
 Biparietal (Crowning) ()
(Head born)(
)

(Crowning) Extension

Pelvic inlet

(Restitution)

LOA restitution
 Restitution LOA

(External rotation)

LOA external rotation

External rotation LOA

 (Expulsion Birth of shoulders , Trunk, Hips , Legs)

-

(Hypomochlion)
Lateral flexion ( )
Pelvic floor Perineum


. Engagement :
. Occipito frontal
. Sub Occipito bregmatic
.
.
.
. Flexion
.
.
. Internal Rotation
.
.
.
. Extension
.

SOB, SOF SOM
.
. Restitution


. External rotation:


. Expulsion



 LOA

(descent )
- Engagement,Flexion
- Internal rotation, Extension
- Restitution, External rotation

(dystocia)