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Fifths palpable (fetal head)

Last reviewed dd mmm yyyy. Last edited dd mmm yyyy

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This term engagement is used in obstetrics to describe when the widest part of the fetal skull has negotiated the pelvic inlet.

Fifths palpable abdominally states what the examiner can palpate on abdominal examination - this makes no degree of judgement on degree of engagement of the fetal head.

In general, the fetal head enters the pelvis by about 37 weeks in a primagravida - if this is not the case then abnormalities such as placenta praevia must be excluded. In contrast, the fetal head may not enter the pelvis until the onset of labour in a multip.


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