Roederer head posture

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Classification according to ICD-10
O64.8 Obstacle to birth due to other position, posture and attitude anomalies
ICD-10 online (WHO version 2019)

The Roederer head posture is a posture anomaly , in this case the child's head is bent prematurely during birth in the pelvic entrance to overcome an obstacle to birth. The mechanically effective circumference (circumferentia fronto-occipitalis) is reduced from approx. 35 cm to approx. 32–33 cm (circumferentia suboccipitobregmatica).

It was named after Johann Georg Roederer (1726–1763) a German physician and first lecturer in obstetrics and professor medicinae extraordinaro at the Clinic for Gynecology and Obstetrics at the Georg-August University in Göttingen .

frequency

Exact information is not available, but the Roederer head posture is very often observed in practice.

causes

  • Maternal Cause: There may be one dystocia in the lower Uterinsegement, a generally vereengtes pool, fibroids are present in the pelvis or a mismatch between the maternal pelvis and childlike head or tumors.
  • The causes in the child can be an unfavorable head shape, for example a reinforced long head , which makes it difficult to adapt to the maternal pelvis. Malformations, like anencephalus , are also possible.

Diagnosis

  • through an internal examination: the small fontanel has already taken the lead in the basin entrance
  • 3rd and 4th Leopold handle : Instead of the head with its transverse diameter, the narrow occiput or the likewise narrow face can be felt
  • In addition, anatomical and functional pelvic diagnostics can be performed

Specialty

The prognosis is generally good. The Roederer head posture can, however, also be combined with other irregularities in the birth process, for example with a high straight position . If the head remains in this position for more than 2 hours with good labor activity and no progress in labor can be recorded, the indication for a caesarean section is given .

therapy

  • Sufficient analgesia of the mother to overcome any existing muscle spasm.
  • Position on the side of the small fontanel or on the side of the child's back in order to help the head step down.

Complications

If the pool entrance proves to be an insurmountable obstacle, another anomaly in attitude and posture can occur. In rare cases, an umbilical cord prolapse (because the head does not seal properly if the bladder ruptures) or the child may experience a lack of oxygen .

literature

  • Mändle, Opitz, Kreuter “The midwifery textbook of practical obstetrics” ISBN 3-7945-1765-2