Asynclitic birth

The parietal bone setting, even Asynklitismus, is an obstetric setting anomaly of the child in the womb, during birth. Here there is an irregular setting the sagittal suture in the pelvic inlet. The sagittal suture is deviated to the front or rear, the front or rear parietal bone is taken the lead.

Classification

Front parietal control (also front or Asynklitismus Naegele's obliquity ): The sagittal suture is deviated laterally to the rear and approached the sacrum. The anterior parietal bone is taken the lead. Here, the baby's head has the ability to possibly narrowed in the straight diameter to overcome the pelvic inlet by means of the so-called buttonhole mechanism. The two head halves happen one after the pelvic inlet. It is a cheap attempt adjustment of the child's head. The spontaneous delivery is possible.

Posterior parietal control (also rear Asynklitismus or Litzmann - obliquity ): The sagittal suture is deviated forward and approached the symphysis. The posterior parietal bone is taken the lead. A descent of is not possible for the head. It is an unfavorable adjustment test of the child's head, because this setting is birth impossible. In most cases a cesarean section is necessary.

Note: front setting: " vörderlich "; rear setting: " hindrance ".

Causes

The peak position of the legs is always an indication of a possible mismatch between the maternal pelvis and childlike head.

• Mother -sided Cause: Unfavorable pool shapes, eg Platte, flat - rachitic or long pool
• Child -sided Cause: Unfavorable head shapes, such as large long head, or hydrocephalus

Diagnostics

The opening period of the birth takes place very delayed. For internal investigation that falls each lead gone parietal bone on. The deviated forward or backward sagittal suture is palpable ( the sagittal suture is not synklitisch = in the lead, but asynkltisch = not lead line). You may be a configuration of a child's skull plates to grope that brings a large scale reduction (about 2 cm) with itself. After rupture of membranes is usually a great birth tumor palpable. There may be a tendency to an attitude anomaly (eg Roederer - head position ). Since the parietal bone setting is often accompanied by a relative or absolute disparity is pre- Beckenaustastung to be concerned about if the premises are a picture. In addition, the Zangemeister handle can be carried out and the Michaelis- pound be assessed.

Therapy and Outcome

First Store at the anterior parietal bone setting only monitoring of the fetal heart rate and uterine activity, the woman giving birth on the side of the fontanel. With good uterine contractions, the head can configure itself and deeper pass through escape into the sacral cavity.

In the posterior parietal leg position can wait for first with thorough monitoring of mother and child, and apparently reasonable space between the child's head and maternal pelvis. To give the child's head the opportunity to be readjusted, the woman can be stored for a few contractions in the knee - elbow position. Does not change the setting of the fetal head, front parietal bone is pressed onto the symphysis until further flexion is no longer possible with increasing labor. The pelvic inlet can not be overcome. By superimposing pushing the parietal bones, the skull hooked stepped to the symphysis, so that a descent of is not possible. The birth should be terminated early by Caesarean section.

Complications

Usually, the ( posterior ) parietal bone setting is associated with a birth arrest. Due to the strong compression of the fetal head may lead to lack of oxygen, cerebral bleeding and pressure necrosis. Since a birth setting impossible and thus a mismatch is present, it may cause hyperkinetic disorders contractions ( contractions storm ); Now there is a risk of a uterine rupture. It must, especially in the posterior parietal bone setting, always pay attention to the Bandl - furrow.

Particularity

Not to be confused is the parietal bone setting with the physiological Asynklitismus. Among the temporary lateral approach of the sagittal suture is understood to the sacrum. This setting is overcome in the further course of labor. It serves, as well as the parietal bone setting, overcoming the pelvic region. The distinction concerning the irregularity is difficult. A veritable setting should arise in the first-time mothers at the beginning, in the multiparous women during the opening period.