Fötales Engagements: Abstieg ins Becken vor der Geburt

Engagement (or “lightening”) is the descent of the fetal presenting part (usually the head) into the maternal pelvis, typically occurring in the weeks before labor in nulliparas, or at labor onset in multiparas.

Clinical Assessment

• Abdominal palpation (Leopold’s maneuvers): Head no longer ballotable; cephalic prominence felt at pelvic brim.
• Station: Measured in cm relative to ischial spines (0 station = engaged). Negative = above; positive = below.
• Ultrasound: Confirms presentation and station.

Significance

• Indicates fetal size/pelvis adequacy.
• May relieve dyspnea (fundus drops) but increase urinary frequency, pelvic pressure.
• Non‑engagement at term in nulliparas may suggest cephalopelvic disproportion (CPD) or malpresentation.

Engagement is a normal preparatory event, not a predictor of exact labor timing.