North American Registry of Midwives (NARM) Practice Exam

How is the cephalic prominence identified in various presentations?

1. By observing the fetal heart rate

2. By comparing it to the fetal back

3. By locating it centrally in the fundus

4. By assessing the engagement of the cervix

The correct answer is: By comparing it to the fetal back

The correct choice focuses on identifying the cephalic prominence by comparing it to the fetal back. In obstetrics, particularly during palpation in labor, healthcare providers can determine the position of the fetus by feeling for specific landmarks. The cephalic prominence refers to the part of the fetal head that is presenting, usually at the top of the fetus's head. By comparing the cephalic prominence to the fetal back, practitioners can accurately assess the orientation of the fetus. This comparison allows for a clearer understanding of the fetal presentation, whether it's in a vertex (head down) position or another presentation. It provides vital information on how labor may progress and informs decisions regarding the most appropriate management for delivery. Other methods, such as evaluating fetal heart rate, locating the head centrally in the fundus, or assessing cervical engagement, do not specifically help in identifying the cephalic prominence and may provide less direct insight into fetal positioning during labor. Therefore, the key to accurately determining the cephalic prominence lies in that tactile comparison with the fetal back, making it a reliable method for assessment.