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Gynaecology & Obstetrics General 3e2bf1e2

A primigravida female comes in labour. The cardinal movements during normal labour occur in which of the following order?

A
Engagement, internal rotation, delivery of head, restitution, external rotation
B
Engagement, internal rotation, restitution, delivery of head, external rotation
C
Engagement, delivery of head, internal rotation, restitution, external rotation
D
Engagement, external rotation, delivery of head, internal rotation, restitution
High-Yield Explanation
The sequence of events occurring during normal labor are engagement, descent, increasing flexion, internal rotation, crowning, delivery of head by extension, restitution, external rotation and delivery of the shoulder and trunk by lateral flexion. During internal rotation, in occipito lateral position there is internal rotation of occiput anteriorly to 2/8th of the circle and simultaneous rotation of the shoulders to 1/8th of the circle. Crowning of head is said to occur when the biparietal diameter stretches the vulval outlet without any recession of the head even after the contraction is over. Delivery of head takes place by extension. Restitution: refers to the visible passive movement of the head due to untwisting of the neck sustained during internal rotation. External rotation is the movement of rotation of head visible externally due to internal rotation of the shoulders. Ref: Textbook of Obstetrics By D.C Dutta, 6th edn, page 126-8.

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