RT Book, Section
A1 Dooley-Hash, Suzanne
A1 Knoop, Kevin J.
A2 Knoop, Kevin J.
A2 Stack, Lawrence B.
A2 Storrow, Alan B.
A2 Thurman, R. Jason
SR Print(0)
ID 1181041765
T1 Emergency Delivery: Normal Vertex Delivery Sequence
T2 The Atlas of Emergency Medicine, 5e
YR 2021
FD 2021
PB McGraw-Hill
PP New York, NY
SN 9781260134940
LK accessmedicine.mhmedical.com/content.aspx?aid=1181041765
RD 2024/04/19
AB A  gravid  woman  may  present  in  any  stage  of  labor.  Those  with  regular  forceful  contractions  and  the  urge  to  push  are  in  active  labor  (2nd  stage)  and  may  be  near  delivery.  This  stage  begins  when  the  cervix  is  fully  dilated,  which  allows  for  the  gradual  descent  of  the  fetal  head  toward  the  vaginal  outlet.  As  the  head  approaches  the  perineum,  the  labia  begin  to  separate  with  each  contraction  and  recede  once  the  contraction  subsides.  Crowning  refers  to  separation  of  the  labia  by  the  head  that  does  not  recede  at  the  end  of  the  contraction.  The  appearance  of  crowning  heralds  imminent  vaginal  delivery.  At  this  point,  transfer  from  the  ED  is  not  advised  and  preparations  for  delivery  should  begin  immediately.