Asynclitism: a literature review of an often forgotten clinical condition.

Authors

• Antonio Malvasi
• Antonio Barbera
• Giovanni Di Vagno
• Alexis Gimovsky
• Vincenzo Berghella
• Tullio Ghi
• Gian Carlo Di Renzo
• Andrea Tinelli

Publication/Presentation Date

11-1-2015

Abstract

Asynclitism is defined as the "oblique malpresentation of the fetal head in labor". Asynclitism is a clinical diagnosis that may be difficult to make; it may be found during vaginal examination. It is significant because it may cause failure of progress operative or cesarean delivery. We reviewed all literature for asynclitism by performing an extensive electronic search of studies from 1959 to 2013. All studies were first reviewed by a single author and discussed with co-authors. The following studies were identified: 8 book chapters, 14 studies on asynclitism alone and 10 papers on both fetal occiput posterior position and asynclitism. The fetal head in a laboring patient may be associated with some degree of asynclitism; this is seen as usual way of the fetal head to adjust to maternal pelvic diameters. However, marked asynclitism is often detected in presence of a co-existing fetal head malposition, especially the transverse and occipital posterior positions. Digital diagnosis of asynclitism is enhanced by intrapartum ultrasound with transabdominal or transperineal approach. The accurate diagnosis of asynclitism, in an objective way, may provide a better assessment of the fetal head position that will help in the correct application of vacuum and forceps, allowing the prevention of unnecessary cesarean deliveries.

Volume

28

Issue

16

First Page

1890

Last Page

1894

ISSN

1476-4954

Published In/Presented At

Malvasi, A., Barbera, A., Di Vagno, G., Gimovsky, A., Berghella, V., Ghi, T., Di Renzo, G. C., & Tinelli, A. (2015). Asynclitism: a literature review of an often forgotten clinical condition. The journal of maternal-fetal & neonatal medicine : the official journal of the European Association of Perinatal Medicine, the Federation of Asia and Oceania Perinatal Societies, the International Society of Perinatal Obstetricians, 28(16), 1890–1894. https://doi.org/10.3109/14767058.2014.972925

Disciplines

Business Administration, Management, and Operations | Health and Medical Administration | Management Sciences and Quantitative Methods

PubMedID

25283847

Department(s)

Administration and Leadership

Document Type

Article