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The importance of asynclitism in birth trauma and intrapartum sonography

Abstract Asynclitism is malposition and malpresentation of the head in the pelvis. It is shown that asynclitism during the configuration (molding) of the head leads to an uneven distribution of the tension forces of the tentorium cerebelli (TC) and to its one-sided ruptures, mainly in the left half. It is indicated that with asynclitism larger more than 15 mm (moderate degree of asynclitism), the risk of birth trauma to the skull and brain increases. It was shown that not only severe degree of asynclitism, but also a moderate degree are pathological due to possible complications. The data on the sonographic diagnosis of asynclitism are presented. The negative effects of vacuum extraction (VE), the forceps application are considered. The mechanism of subaponeurotic hemorrhages is described. The importance of timely asynclitism diagnosis in labor to prevent its complication is shown. The cesarean section is practiced as extreme solution to the problem. The widespread use of sonography for the asynclitism diagnosis will prevent the birth trauma and reduce the incidence of mobility and mortality of the children and mother.