(a) Complete flexion. This is normal attitude in cephalic presentation.
With cephalic, there is complete flexion at the head when the fetus "chin is on his
chest." This allows the smallest cephalic diameter to enter the pelvis, which gives the
fewest mechanical problems with descent and delivery.
(b) Moderate flexion or military attitude. In cephalic presentation, the
fetus head is only partially flexed or not flexed. It gives the appearance of a military
person at attention. A larger diameter of the head would be coming through the
passageway.
(c) Poor flexion or marked extension. In reference to the fetus head, it
is extended or bent backwards. This would be called a brow presentation. It is difficult
to deliver because the widest diameter of the head enters the pelvis first. This type of
cephalic presentation may require a C/Section if the attitude cannot be changed.
(d) Hyperextended. In reference to the cephalic position, the fetus
head is extended all the way back. This allows a face or chin to present first in the
pelvis. If there is adequate room in the pelvis, the fetus may be delivered vaginally.
(2)
Areas to look at for flexion.
(a)
Head-iscussed in previous paragraph, 10-2c(1).
(b) Thighs-flexed on the abdomen.
(c)
Knees-flexed at the knee joints.
(d)
Arches of the feet-rested on the anterior surface of the legs.
(e) Arms-crossed over the thorax.
(3) Attitude of general flexion. This is when all of the above areas are flexed
appropriately as described.
d. Station. This refers to the depth that the presenting part has descended into
the pelvis in relation to the ischial spines of the mother's pelvis. Measurement of the
station is as follows:
(1) The degree of advancement of the presenting part through the pelvis is
measured in centimeters.
(2)
The ischial spines is the dividing line between plus and minus stations.
(3) Above the ischial spines is referred to as -1 to -5, the numbers going
higher as the presenting part gets higher in the pelvis (see figure10-3).
MD0921
10-4