Medical expert of the article
New publications
Failure of the fetus to descend anteroposteriorly
Last reviewed: 08.07.2025
All iLive content is medically reviewed or fact checked to ensure as much factual accuracy as possible.
We have strict sourcing guidelines and only link to reputable media sites, academic research institutions and, whenever possible, medically peer reviewed studies. Note that the numbers in parentheses ([1], [2], etc.) are clickable links to these studies.
If you feel that any of our content is inaccurate, out-of-date, or otherwise questionable, please select it and press Ctrl + Enter.
Progressive movement of the presenting part of the fetus in the pelvic cavity (descent) is an important sign of normal labor. Descent usually begins with maximum dilation of the cervix and is easily observed in the deceleration phase and especially in the second stage of labor. In some women in labor, descent is completely absent.
Diagnostics. To establish a diagnosis, it is necessary to confirm the absence of descent of the presenting part of the fetus during the second stage of labor. In most cases, the inability to descend is associated with the presence of other abnormalities of labor - 94.1% of women in labor had secondary cessation of cervical dilation, 78.4% had concomitant disorders caused by slowing down of labor. Most often, the diagnosis is made on the basis of two vaginal examinations, which are carried out at an interval of 1 hour during the second stage of labor.
Frequency: This anomaly complicates 3.6% of births.
Causes: The vast majority of women in labor with the inability to further lower the presenting part of the fetus have a discrepancy between the size of the fetus and the mother's pelvis.
Prognosis: Since women in labor who have obstructed passage of the fetus through the birth canal require a cesarean section, the prognosis should be given with caution.
Management of labor with failure to descend the presenting part of the fetus
Pregnant women with the impossibility of further fetal advancement through the birth canal require immediate cesarean section. In such cases, size discrepancy is too common an etiologic factor, so it is better to mistakenly perform a cesarean section in some women who could have had a vaginal birth if it had developed further, rather than face the numerous complications observed in most women in labor with size discrepancy between the fetus and the mother's pelvis.
[