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    The Fetal Skull: Reproductive Health I Clinical Medicine Class

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    moreen kipkemoi
    The fetal skull is large relative to the fetal body and maternal pelvis. It is made up of several bones that are not fully fused at birth, allowing the skull to flex, mold, and pass through the birth canal. Key features include soft spots called fontanelles and gaps between bones called sutures that permit overlap during birth. The fetal skull has characteristic diameters and regions that are important considerations in assessing its relationship to the maternal pelvis during labor and delivery.

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    The Fetal Skull: Reproductive Health I Clinical Medicine Class

    Uploaded by

    moreen kipkemoi
    39 views30 pages
    The fetal skull is large relative to the fetal body and maternal pelvis. It is made up of several bones that are not fully fused at birth, allowing the skull to flex, mold, and pass through the birth canal. Key features include soft spots called fontanelles and gaps between bones called sutures that permit overlap during birth. The fetal skull has characteristic diameters and regions that are important considerations in assessing its relationship to the maternal pelvis during labor and delivery.

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    THE FETAL SKULL

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    The fetal skull is large relative to the fetal body and maternal pelvis. It is made up of several bones that are not fully fused at birth, allowing the skull to flex, mold, and pass through the birth canal. Key features include soft spots called fontanelles and gaps between bones called sutures that permit overlap during birth. The fetal skull has characteristic diameters and regions that are important considerations in assessing its relationship to the maternal pelvis during labor and delivery.

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    © All Rights Reserved
    Download as PPTX, PDF, TXT or read online from Scribd
    Download as pptx, pdf, or txt
    39 views30 pages

    The Fetal Skull: Reproductive Health I Clinical Medicine Class

    Uploaded by

    moreen kipkemoi
    The fetal skull is large relative to the fetal body and maternal pelvis. It is made up of several bones that are not fully fused at birth, allowing the skull to flex, mold, and pass through the birth canal. Key features include soft spots called fontanelles and gaps between bones called sutures that permit overlap during birth. The fetal skull has characteristic diameters and regions that are important considerations in assessing its relationship to the maternal pelvis during labor and delivery.

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    THE FETAL SKULL

    REPRODUCTIVE HEALTH I
    CLINICAL MEDICINE CLASS
    Fetal skull
    • The fetal head is large in relation to the fetal
    body compared with the adult.
    • Additionally, it is large in comparison with the
    maternal pelvis and is the largest part of the fetal
    body to be born.
    • Adaptation between the skull and the pelvis is
    necessary to allow the head to pass through the
    pelvis during labor without complications.
    Division of the skull
    • The vault is the large, dome-shaped part above
    an imaginary line drawn between the orbital
    ridges and the nape of the neck.
    • The base comprises bones that are firmly united
    to protect the vital centers in the medulla
    oblongata.
    • The face is composed of 14 small bones
    Bones of the vault
    • The bones of the vault are laid down in membrane.
    • They harden from the center outwards in a process
    known as ossification.
    • Ossification is incomplete at birth, leaving small gaps
    between the bones, known as the sutures and
    fontanelles.
    • The ossification center on each bone appears as a
    protuberance
    • The occipital bone, which lies at the back of the
    head.
    Part of it contributes to the base of the skull as it
    contains the foramen magnum, which protects
    the spinal cord as it leaves the skull.
    The ossification center is the occipital
    protuberance.
    • The two parietal bones, which lie on either side
    of the skull.
    The ossification center of each of these bones is
    called the parietal eminence.
    • The two frontal bones, which form the
    forehead or sinciput.
    The ossification center of each bone is the
    frontal eminence. The frontal bones fuse into a
    single bone by eight years of age.
    • The upper part of the temporal bone on both
    sides of the head forms part of the vault.
    Sutures and fontanelles
    • The sutures are the cranial joints formed where
    two bones meet.
    • Where two or more sutures meet, a fontanelle is
    formed.
    • The sutures and fontanelles permit a degree of
    overlapping of the skull bones during labor,
    which is known as moulding.
    • The lambdoidal suture separates the occipital bone
    from the two parietal bones.
    • The sagittal suture lies between the two parietal
    bones.
    • The coronal suture separates the frontal bones from
    the parietal bones, passing from one temple to the
    other.
    • The frontal suture runs between the two halves of the
    frontal bone.
    • Whereas the frontal suture becomes obliterated in
    time, the other sutures eventually become fixed joints.
    • The posterior fontanelle or lambda (shaped like
    the Greek letter lambda λ) is situated at the
    junction of the lambdoidal and sagittal sutures.
    It is small, triangular in shape and can be
    recognized vaginally because a suture leaves
    from each of the three angles.
    It normally closes by 6 weeks of age.
    • The anterior fontanelle or bregma is found at the
    junction of the sagittal, coronal and frontal
    sutures.
    It is broad, kite-shaped ◆ and recognizable
    vaginally because a suture leaves from each of the
    four corners.
    It measures 3–4 cm long and 1.5–2 cm wide and
    normally closes by 18 months of age.
    Pulsations of cerebral vessels can be felt through
    this fontanelle.
    Regions and landmarks of the fetal skull
    • The occiput region lies between the foramen magnum
    and the posterior fontanelle.
    • The part below the occipital protuberance
    (landmark) is known as the sub-occipital region.
    • The vertex region is bounded by the posterior
    fontanelle, the two parietal eminences and the anterior
    fontanelle.
    • The forehead/sinciput region extends from the
    anterior fontanelle and the coronal suture to
    the orbital ridges.
    • The face extends from the orbital ridges and
    the root of the nose to the junction of the chin
    or mentum(landmark) and the neck.
    • The point between the eyebrows is known as
    the glabella.
    Diameters of the fetal skull
    • Knowledge of the diameters of the skull
    alongside the diameters of the pelvis allows
    the midwife to determine the relationship
    between the fetal head and the mother’s
    pelvis.
    • The sub-occipitobregmatic (SOB) diameter (9.5 cm)
    measured from below the occipital protuberance to
    the center of the anterior fontanelle or bregma.
    • The sub-occipitofrontal (SOF) diameter (10 cm)
    measured from below the occipital protuberance to
    the center of the frontal suture.
    • The occipitofrontal (OF) diameter (11.5 cm)
    measured from the occipital protuberance to the
    glabella.
    • The mentovertical (MV) diameter (13.5 cm)
    measured from the point of the chin to the highest
    point on the vertex.
    • The sub-mentovertical (SMV) diameter (11.5 cm)
    measured from the point where the chin joins the
    neck to the highest point on the vertex
    • The sub-mentobregmatic (SMB) diameter (9.5 cm)
    measured from the point where the chin joins the
    neck to the center of the bregma (anterior
    fontanelle).
    • Biparietal- 9.5 cm
    • Bitemporal- 8.2 cm
    Presenting diameters
    • The presenting diameters of the head are
    those that are at right-angles to maternal
    pelvis.
    • Vertex presentation.
    -When the head is well flexed the sub-
    occipitobregmatic diameter (9.5 cm) and the
    biparietal diameter (9.5 cm) present, which is the
    most favorable.
    -The diameter that distends the vaginalorifice is the
    sub-occipitofrontal diameter (10 cm).
    -When the head is deflexed, the presenting
    diameters are the occipitofrontal (11.5 cm) and the
    biparietal (9.5 cm).
    This situation often arises when the occiput is in a
    posterior position.
    -If it remains so, the diameter distending the vaginal
    orifice will be the occipitofrontal (11.5 cm).
    • Face presentation.
    -When the head is completely extended the
    presenting diameters are the submentobregmatic(9.5
    cm) and the bitemporal(8.2 cm). The sub-
    mentovertical diameter (11.5 cm) will distend the
    vaginal orifice.
    • Brow presentation.
    -When the head is partially extended, the
    mentovertical diameter (13.5 cm) and the
    bitemporal diameter (8.2 cm) present.
    -If this presentation persists, vaginal birth is
    unlikely.

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