North American Registry of Midwives (NARM) Practice Exam

Which of the following is NOT one of the basic positional movements during a cephalic vertex presentation?

1. Engagement

2. Transverse lie

3. Internal Rotation

4. Restitution

The correct answer is: Transverse lie

In a cephalic vertex presentation, the basic positional movements involved include engagement, internal rotation, and restitution. Each of these movements plays a crucial role in the process of labor and delivery. Engagement refers to the process where the fetal presenting part moves into the pelvic inlet. This is a critical first step, as it indicates that the presenting part is entering the birth canal in preparation for birth. Internal rotation involves the fetus rotating to align its body with the pelvis as it moves down through the birth canal. This movement is essential for the successful delivery of the baby in a head-first presentation. Restitution occurs after the fetal head is born, during which it naturally realigns with the fetal body. This alignment is important for facilitating the delivery of the shoulders and the rest of the body. Transverse lie, on the other hand, is not a movement associated with the normal progression of a cephalic vertex presentation. Instead, it describes a situation where the fetus is positioned horizontally across the uterus, which is not compatible with vaginal delivery in a vertex presentation. Therefore, identifying transverse lie as the option that does not belong is based on its distinction from the standard movements that occur in a cephalic vertex presentation.