A L

E T
F L L PREPARED BY
U
SK Ms.Annu Panchal
Assistant Professor
FETAL SKULL: LATERAL VIEW
 AREAS OF SKULL
 It consists of
1) Vault
2) Face
3) Base.
 VAULT

 The vault is composed of:

 2 frontal bones separated by the frontal
suture,
 2 parietal bones separated by the sagittal
suture,
 the occipital bone separated by the
lambdoidal suture from the parietal bones,
while the coronal suture separates the
frontal from the parietal bones.
 REGIONS OF FETAL SKULL
Regions of the fetal skull have been designated to aid in the
description of the presenting part felt at vaginal examination
during labour
Occiput = the area lying behind posterior fontanelle
Vertex = the area between anterior and posterior
fontanelles and between parietal eminences
Bregma = area around anterior fontanelle
Sinciput = area lying in front of anterior fontanelle.
 This is subdivided into 2 part – the brow and the face
Brow = area between anterior fontanelle and root of the
nose
Face = area below the root of the nose
 SUTURES

Sagittal or Longitudinal Suture: lies between two

parietal bones.

Coronal sutures : run between parietal and frontal

bones on either side.

Frontal suture: lies between two frontal bones

Lambdoid sutures: separate the occipital bone and

two parietal bones.
 Coronal suture

Lambdoi
d suture
Sagittal suture
 OTHER SUTURES

1. Metopic (frontal) suture

2. Intermaxillary suture
3. Intermandibular sutures
 Frontal suture

Intermaxillary
sutures

Intermandibular
BONES OF THE FETAL
SKULL
 Frontal bones- 2

 Parietal bones-2

 Temporal bones-2

 Occipital bone-1
 FONTANELLES
Fontanelle = Areas of fibrous tissue membrane separating the
bones of the calvaria
Wide gap in the suture line is called fontanelle. Of the many
fontanelles (6 in number)
Major fontanelles:
1) Anterior
2) Posterior
3)Anterolateral (Sphenoidal)
4) Posterolateral (Mastoid)
Posterior fontanelle

Anterior
fontanelle

Anterolateral
(sphenoid)
fontanelle

Posterolateral (mastoid)
fontanelle
 ANTERIOR FONTANELLE

It is formed by joining of the four sutures in

the mid plane. Anteriorly frontal suture,
posteriorly sagittal suture and on either
side,coronal sutures. Anterior fontanelle
Diamond shaped
Size : 3cm x 2 cm
Ossification : 18 months after birth
 POSTERIOR FONTANELLE

It formed by junction of three suture lines-

sagittal suture anteriorly and lambdoidal
suture on either side.
Triangular in shape
Size: 1.2 cm x 1.2 cm
Posterior fontanelle

Begins to close at term

Anterior Fontanelle (Bregma) Posterior Fontanelle (Lambda)

Large, and lozenge-shaped Small and triangular

Its floor is membranous Its floor is bony.

Surrounded by 4 bones. Surrounded by 3 bones.

(2 frontal and 2 parietal) (2 parietal and occipital)

The surrounding bones are not The surrounding bones are overlapping
overlapping during moulding. during moulding.
DIAMETERS OF FOETAL SKULL
 Longitudinal diameters
 Suboccipito-bregmatic = 9.5cm
 from below the occipital protuberance to the centre of the
anterior fontanelle (bregma).
 It is the engagement diameter in occipito-anterior with
complete flexion.

 Suboccipito-frontal = 10 cm
 from below the occipital protuberance to the anterior end of
the bregma.
 It is the engagement diameter in occipito anterior with
incomplete flexion.
 Occipito-frontal = 11.5 cm
 form the occipital protuberance to the root of the nose.
 It is the engagement diameter in occipito-posterior position.
 It is the diameter that distends the vulva in face to pubis delivery.
 It is the diameter that distends the vulva if the head extends
before crowing in occipito anterior.\

 Submento-bregmatic = 9.5 cm
 from the junction of the chin and neck to the centre of the
bregma.
 It is the engagement diameter in face presentation when the head
is completely extended.
 Submento-vertical =11.5 cm
 from the junction of the chin and neck to the vertical point
which is a point on the sagittal suture midway between anterior
and posterior fontanelles.
 It is the engagement diameter in the incompletely extended
face.
 It is the diameter that distends the vulva during face delivery.

 Mento-vertical =13.5 cm or 14 cm
 from the tip of the chin to the vertical point.
 It is the engagement diameter in brow presentation. As it is
longer than the largest diameter of the pelvic brim, the head
cannot enter the pelvis.
 Transverse diameters
 Biparietal =9.5 cm
 between the 2 parietal eminencies.
 Super subparietal = 9cm
 from below one parietal eminence to above the opposite
eminence.
 It is the engagement diameter in case of asynclitism.
 Bitemporal = 8 cm
 between the anterior ends of the temporal sutures./li>
 Bimastoid = 7.5cm
 between the tips of the 2 mastoid processes.
 MOLDING OF FETAL SKULL
 Moulding = adaptation of fetal head to the pelvic
cavity during birth
 To reduce head circumference
 Moulding is the alteration of the shape of the
forecoming foetal head while passing through
the resistant birth passage during labour.
• Frontal bones slip under parietal bones
• Parietal bones override each other
• Occipital bone slip under the parietal bones
GRADING :

Grade I – The bones just touching but not

overlapping
Grade II- Overlapping of bone but can be
separated

Grade III- Fixed overlapping.