MOULDING

 FETAL SKULL

MOULDING

DEFINITION

MOULDING

This is the change in the shape of the fetal skull as it passes through the pelvis during delivery process due to overriding or overlapping of the fetal skull bones

TYPES OF MOULDING

1. EXCESSIVE MOULDING

This is the type of moulding that occurs due to obstructed labour especially one caused by cephalopelvic disproportion.

It can also occur in premature babies due to large sutures and soft skull bones which offer little resistance to the pressure

2. SUDDEN OR RAPID MOULDING

This type of moulding is common in precipitate labour and after coming of the head in breech presentation due to rapid expulsion of the fetus from the birth canal

3. UPWARD MOULDING

This type of moulding happens when the attitude of the fetus is that of deflexion and also in occipital posterior position.

GRADES OF MOULDING

1. GRADE 0

This is when there's no moulding at all. Bones remaining in the same position.

2. GRADE 1

This is when moulding occurs and the skull bones are in apposition for they do not overlap.

3. GRADE 2

This is when moulding occurs and the Skull bones overlap but upon digital pressure they are reduceable.

4. GRADE 3

This is when moulding occurs and the Skull bones overlap but upon digital pressure they are NON reduceable.

IMPORTANCE OF MOULDING

1. AID IN PROGRESS OF LABOR

Moulding of the fetal skull bones helps to reduce the fetal diameters thereby promoting progress of labour.

2. AID IN ENGAGEMENT

Moulding allows the widest diameters of the fetal skull to engage into the pelvis.

3. AID IN NEGOTIATIONS

Moulding of the fetal skull bones helps the fetus to pass well in the maternal pelvis

4. AID IN DESCENT

When moulding occurs, the fetus is less likely to face obstruction or resistance making it to descend well and be born.