FETAL SKULL

prepared by
NSM Suhaila Amzi binti Ismail
ADMW Mac 2014

FETAL SKULL
The bone structure of the head of the fetus.
Are formed of membrance
This membrance are five points called ossification centres.
Early skull development occur at the end of the 4th week of
intrauterine life
Commence in the occiput
Fetal skull divided into 3 regions.
i. Vault
-area above an imaginary line drawn from below
the occipital protuberance to the orbital ridges
ii. Face
- area extending from the ortibal ridges to the
junction of the chin and neck.
iii. Base
-bones in this area are also
frimly united and help to protect the brain.

BONES
1) Occiput :
) One bones which lies posteriorly
) Ossification centre can be easily defined
) Is named the occipital protuberance
2) Parietals :
) laterally, on the right and left are the parietal bones with
their ossification centres, the parietal eminences
3) Frontals :
) Anteriorly lie the right and left frontal bones
) Whose ossification centers are named
eminences or frontal bones

frontal

SUTURE AND FONTANELLE OF FETAL

SKULL AND THEIR SIGNIFICANT
SUTURE
Membrance between the skull bones
Ossification has not been complate
TYPE OF SUTURE
1) Lamboidal Suture
) Lies between the occiput and the two parietal bones
2) Sagittal Suture
) Divides two parietal bones
3) Coronal Suture
) Separates the parietal bones from the frontal boned
4) Frontal Suture
) Divides the frontal bones

SUTURE AND FONTANELLE OF FETAL

SKULL AND THEIR SIGNIFICANT
FONTANELLE
1) These are area where two or more suture meet
2) Only two need to be mentioned
A. ANTERIOR FONTANELLE
) Diamond shape where sagittal, coronal and frontal
sutures meet. At the junction of the saggital, coronal and
frontal suture
) 2.5cm length and 1.3 wide
) The size help for vaginal examination
) The anterior fontanelle should be completely ossified by
the time that the infant 18 months of age

SUTURE AND FONTANELLE OF FETAL

SKULL AND THEIR SIGNIFICANT

B. POSTERIOR FONTANELLE
Juncation of the lamboidal and sagittal sutures
Small triangular in shape and close until 6 months
Can be recognised characteristic because it will just admit
a finger tip and three sutures can be distinguised
Fetus with lying his chin well down on this chest and
head is therefore well flexed and allow the skull to pass
through
Relationship of the fetal skull to one of the four
quadrants of mothers
The occiput must be lying in right anterior quadran of the
pelvis is said to be right occipitoanterior

NORMAL SKULL OF
THE NEWBORN

REGION OF THE SKULL

The occiput region lies between the foramen
magnum and the posterior fontanelle. The fault
below the occipital protubance is known as the
suboccipital region.
The vertex region bounded by posterior, two
periatal eminence and the anterior fontanelle.
The forehead/sinciput region extend from the
anterior fontanelle coronal suture to the orbital
ridges.
The face extend from the orbital ridges of the
nose to the junction of the chin the neck. The point
between the eyebow is known as the glabella

THE BONES OF THE VAULT AND

THEIR SIGNIFICANT
1. The occipital bone-lie at the back of the head. Part of
it contribute to the base of the skull as it contain the
foramen magnum, which protect the spinal cord as
it leaves the skull-the ossification centre is the
occiptal protuberance
2. The 2 parietal bones-lie on the either side of the
skull.The ossification centre of each is called the
parietal eminence.
3. Frontal bones-the 2 bones from the forehead or
sinciput. The ossification centre of each is the
frontal eminence fused into a single bone by 8 years
of age.
4. The upper part of the temporal bone on both sides
of the head form of the vault.

THE BONES OF THE VAULT AND

THEIR SIGNIFICANT

DIAMETER OF THE FETAL SKULL

Alongside the diameters of the pelvis allows midwifes to
determine relationship between fetal head and the mother
pelvis.
The are have 8 diameters, 6 longitudinal diameters and 2
transverse diameters.
The longitudinal diameters :
1.

SOB (sub-occiptobregmentic) 9.5 cm

- measured from below the occipital protuberance to the
centre of the anterior fontanelle/bregma. When the head
is well fiexed SOB presented.
2. SOF (sub-occipitofrontal) 10 cm
- from bellow the occipital proberance to the centre of the
frontal suture.

DIAMETER OF THE FETAL SKULL

3. OF (occipitofrontal) 11.5 cm
-from the occipital portuberance to the glabell a (bony
prominence formed by the joining of the frontal bones
and supraorbital ridges.
4. MV (mentovertical) 13.5 cm
- from paint the chin to the highest point on the vertex,
slightly nearer to the prosterior than to the anterior
fontanelle.
5. SMW (sub-mentovertical) 11.5 cm
- from the point where chin joins the neckto the highest
point on the vertex (top of fetal head bounded by the
anterior or posterior fontanelles and the parietal
eminences)
6. SMB (sub-mentobregmatic) 9.5 cm
- from the point where the chin joins the neck to the
centre of the bregma.

DIAMETER OF THE FETAL SKULL

DIAMETER OF THE FETAL SKULL

1. Biparietal diameter (9.5 cm)
) Between the two parietal eminences
2. Bitemporal diameter (8.2 cm)
) Between the furthest points of the coronal suture at the
temples.

Bitemporal 8.2 cm

IDENTIFY THE REGION OF THE FETAL

SKULL ON VAGINAL EXAMINATION
Normal attitude of the fetus in utero is one flexion, the head
being flexed on the chest and the back curved towards the
maternal abdominal wall.
1. A well-flexed head (vertex presentation)
) The diameter of the fetal skull which engages in the pelvic
brim is the suboccipitobregmatic of 9.5 cm
) The bi parietal diameter (9.5 cm) present
) As there 2 diameters are the same length, the presenting
area is circular, which is the most favorable shape, for
dilating the cervix and berth of the head
) The diameter that distends the vaginal orifice is the suboccipitofrontal diameter (10 cm)
) When the head is deflexed, the presenting diameters are
the occipitofrontal (11.5 cm) and the bipariental (9.5 cm),
this situation often arises when the occiput is in a
posterior

IDENTIFY THE REGION OF THE FETAL

SKULL ON VAGINAL EXAMINATION
2. Descent with no flexion of the head
) A failure of the head to flex and it descends through the
pelvic result in the occipitofrontal diameter (11.5 cm)
3. Descent of head with incomplete flexion
) Fetal skull are usually relatively favourable in comparison
with the size of the mothers pelvis and spontaneous
delivery occurs
) If fetal head not flexed, delivery is managed by allowing
the smallest possible diameters of the head to distend the
perineum
) This
condition
is
described
as
unreduced
occipitoposterior position or face to pubes

IDENTIFY THE REGION OF THE FETAL

SKULL ON VAGINAL EXAMINATION
4. Descent with slight extension brow presentation
) When the head is partly extended the engaging diameter
is the mentovertical (13 cm) and the presentation is brow.
The maternal pelvis cannot accommodate this large
diameter and delivery is affected by caesarian section
5. Descent with full extension face presentation
) The chin becomes the leading part. Providing that the
chin descends to the pelvic floor and rotate anteriorly,
svd occurs as a face presentation
) When the head is completely extended presenting
diameter is SMB (9.5 cm) and bitemporal (8.2 cm) will
distend the vaginal orifice.