Effect of Head Position at Birth on WISC Verbal and Performance IQ

Churchill, John A.; Willerman, Lee; Grisell, James L.; Ayers, Melvern A.

doi:10.2466/pr0.1968.23.2.495

Cited by 3 publications

(1 citation statement)

References 5 publications

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“…The bones of the fetal calvarium are usually relatively thin, not fully calcified, and unfused. These features increase compliance and make them vulnerable to changes in shape and position during labor according to constraints imposed by contractions, maternal pushing, and the bony and soft tissue elements of the birth canal [23] [48]. Normal molding is another means by which the fetus adapts to external pressures on its head.…”

Section: Fetal Head Moldingmentioning

confidence: 99%

Fetal Head Compression: Its Possible Role in Neurologic Injury

Schifrin,

Koos,

Cohen

2024

OJOG

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It is widely assumed that fetal ischemic brain injury during labor derives almost exclusively from severe, systemic hypoxemia with marked neonatal depression and acidemia. Severe asphyxia, however, is one of several causes of perinatal neurological injury and may not be the most common; most neonates diagnosed with hypoxic-ischemic encephalopathy do not have evidence of severe asphyxia. Sepsis, direct brain trauma, and drug or toxin exposure account for some cases, while mechanical forces of labor and delivery that increase fetal intracranial pressure sufficiently to impair brain perfusion may also contribute. Because of bony compliance and mobile suture lines, the fetal skull changes shape and redistributes cerebrospinal fluid during labor according to constraints imposed by contractions, and bony and soft tissue elements of the birth canal as the head descends. These accommodations, including the increase in intracranial pressure, are adaptive and necessary for efficient descent of the head while safeguarding cerebral blood flow. Autonomic reflexes mediated through central receptors normally provide ample protection of the brain from the considerable pressure exerted on the skull. On occasion, those forces, which are transmitted intracranially, may overcome the various adaptive anatomical, cardiovascular, metabolic, and neurological mechanisms that maintain cerebral perfusion and oxygen availability, resulting in ischemic brain injury. Accepting the notion of a potentially adverse impact of fetal head compression suggests that avoidance of excessive uterine activity and of relentless pushing without steady progress in descent may offer protection for the fetal brain during parturition. Excessive head compression should be considered in the differential diagnosis of ischemic encephalopathy.

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Section: Fetal Head Moldingmentioning

confidence: 99%

Fetal Head Compression: Its Possible Role in Neurologic Injury

Schifrin,

Koos,

Cohen

2024

OJOG

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Pre-Natal Environmental Influences on Behaviour

Barrett

1971

A Handbook of Pre-Natal Paediatrics for Obstetricians and Pediatricians

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Some important factors in the molding of the fetal head during vaginal delivery ‐ A photographic study

Sorbe

Dahlgren

1983

Intl J Gynecology & Obste

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The molding of the fetal head was studied in 319 vaginal deliveries. A photographic method was used to document the size and form of the infants' heads immediately postpartum and 3 days later. Six different diameters were measured but only three changed significantly during early neonatal restitution. A molding index was calculated and compared with the conventional occipitofrontal circumference. Infants born by primiparous women showed significantly higher degrees of molding of the head than those born by multiparous women. Oxytocin stimulation during labor as well as instrumental deliveries resulted in increased fetal head molding. The importance of fetal presentation at birth, the duration of labor, the age of the mother and birth weight of the infant was also analyzed with regard to the molding of the fetal skull during labor.

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Effect of Head Position at Birth on WISC Verbal and Performance IQ

Cited by 3 publications

References 5 publications

Fetal Head Compression: Its Possible Role in Neurologic Injury

Fetal Head Compression: Its Possible Role in Neurologic Injury

Pre-Natal Environmental Influences on Behaviour

Some important factors in the molding of the fetal head during vaginal delivery ‐ A photographic study

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