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Crowning

MedGen UID:
452281
•Concept ID:
C0233212
•
Sign or Symptom
Synonym: Crowning during Childbirth
SNOMED CT: Crowning (89934007)

Definition

The characteristic sign of impending birth during the second stage of labor. The presenting part of the head of fetus is visible and firmly rimmed by the maternal vaginal wall. [from NCI]

Professional guidelines

PubMed

Perineal prevention and protection in obstetrics: CNGOF clinical practice guidelines.
Ducarme G, Pizzoferrato AC, de Tayrac R, Schantz C, Thubert T, Le Ray C, Riethmuller D, Verspyck E, Gachon B, Pierre F, Artzner F, Jacquetin B, Fritel X
J Gynecol Obstet Hum Reprod 2019 Sep;48(7):455-460. Epub 2018 Dec 12 doi: 10.1016/j.jogoh.2018.12.002. PMID: 30553051
Treatment of Cracked Teeth.
Alkhalifah S, Alkandari H, Sharma PN, Moule AJ
J Endod 2017 Sep;43(9):1579-1586. Epub 2017 Jul 19 doi: 10.1016/j.joen.2017.03.029. PMID: 28734650
Occurrence and management of dental fluorosis.
Akpata ES
Int Dent J 2001 Oct;51(5):325-33. doi: 10.1002/j.1875-595x.2001.tb00845.x. PMID: 11697585

Recent clinical studies

Etiology

Lateral episiotomy or no episiotomy in vacuum assisted delivery in nulliparous women (EVA): multicentre, open label, randomised controlled trial.
Bergendahl S, Jonsson M, Hesselman S, Ankarcrona V, Leijonhufvud Å, Wihlbäck AC, Wallström T, Rydström E, Friberg H, Kopp Kallner H, Brismar Wendel S
BMJ 2024 Jun 17;385:e079014. doi: 10.1136/bmj-2023-079014. PMID: 38886011Free PMC Article
Selective Episiotomy: Indications, Techinique, and Association with Severe Perineal Lacerations.
Corrêa Junior MD, Passini Júnior R
Rev Bras Ginecol Obstet 2016 Jun;38(6):301-7. Epub 2016 Jul 11 doi: 10.1055/s-0036-1584942. PMID: 27399925Free PMC Article
Articulating the Case for the Longevity Dividend.
Olshansky SJ
Cold Spring Harb Perspect Med 2016 Jan 8;6(2):a025940. doi: 10.1101/cshperspect.a025940. PMID: 26747832Free PMC Article
Timing of episiotomy and outcome of a non-instrumental vaginal delivery.
Rusavy Z, Karbanova J, Kalis V
Acta Obstet Gynecol Scand 2016 Feb;95(2):190-6. Epub 2015 Dec 8 doi: 10.1111/aogs.12814. PMID: 26563626
A review of evidence-based practices for management of the second stage of labor.
Kopas ML
J Midwifery Womens Health 2014 May-Jun;59(3):264-76. doi: 10.1111/jmwh.12199. PMID: 24850283

Diagnosis

Congenital melanocytic nevi in Bardet-Biedl syndrome.
Shelton K, Dang P, McCorkle C, Mallipaddi P, Hollman N, Pomeroy J, Richards J
Orphanet J Rare Dis 2025 Aug 28;20(1):462. doi: 10.1186/s13023-025-03870-6. PMID: 40877950Free PMC Article
Lateral episiotomy or no episiotomy in vacuum assisted delivery in nulliparous women (EVA): multicentre, open label, randomised controlled trial.
Bergendahl S, Jonsson M, Hesselman S, Ankarcrona V, Leijonhufvud Å, Wihlbäck AC, Wallström T, Rydström E, Friberg H, Kopp Kallner H, Brismar Wendel S
BMJ 2024 Jun 17;385:e079014. doi: 10.1136/bmj-2023-079014. PMID: 38886011Free PMC Article
The CROWNing Event on Hair Loss in Women of Color: A Framework for Advocacy and Community Engagement (FACE) Survey Analysis.
Hobbs LK, Brown S 3rd, Smith RJ, Salkey K, Harvey V
Cutis 2022 Oct;110(4):189-193. doi: 10.12788/cutis.0631. PMID: 36446092
Perineal prevention and protection in obstetrics: CNGOF clinical practice guidelines.
Ducarme G, Pizzoferrato AC, de Tayrac R, Schantz C, Thubert T, Le Ray C, Riethmuller D, Verspyck E, Gachon B, Pierre F, Artzner F, Jacquetin B, Fritel X
J Gynecol Obstet Hum Reprod 2019 Sep;48(7):455-460. Epub 2018 Dec 12 doi: 10.1016/j.jogoh.2018.12.002. PMID: 30553051
Breast cancer imaging: the future.
Jochelson M
Semin Oncol 2001 Jun;28(3):221-8. doi: 10.1016/s0093-7754(01)90114-9. PMID: 11402431

Therapy

Lateral episiotomy or no episiotomy in vacuum assisted delivery in nulliparous women (EVA): multicentre, open label, randomised controlled trial.
Bergendahl S, Jonsson M, Hesselman S, Ankarcrona V, Leijonhufvud Å, Wihlbäck AC, Wallström T, Rydström E, Friberg H, Kopp Kallner H, Brismar Wendel S
BMJ 2024 Jun 17;385:e079014. doi: 10.1136/bmj-2023-079014. PMID: 38886011Free PMC Article
The Biological Impact of Menthol on Tobacco Dependence.
Wickham RJ
Nicotine Tob Res 2020 Oct 8;22(10):1676-1684. doi: 10.1093/ntr/ntz239. PMID: 31867627
The optimal angle of the mediolateral episiotomy at crowning of the head during labor.
Ginath S, Elyashiv O, Weiner E, Sagiv R, Bar J, Menczer J, Kovo M, Condrea A
Int Urogynecol J 2017 Dec;28(12):1795-1799. Epub 2017 May 5 doi: 10.1007/s00192-017-3349-9. PMID: 28477150
Selective Episiotomy: Indications, Techinique, and Association with Severe Perineal Lacerations.
Corrêa Junior MD, Passini Júnior R
Rev Bras Ginecol Obstet 2016 Jun;38(6):301-7. Epub 2016 Jul 11 doi: 10.1055/s-0036-1584942. PMID: 27399925Free PMC Article
Occurrence and management of dental fluorosis.
Akpata ES
Int Dent J 2001 Oct;51(5):325-33. doi: 10.1002/j.1875-595x.2001.tb00845.x. PMID: 11697585

Prognosis

Italian contributions to the history of acute myocardial infarction treatment.
Bolognese L, Reccia MR, Sabini A
Minerva Cardiol Angiol 2024 Feb;72(1):32-40. Epub 2023 Jun 13 doi: 10.23736/S2724-5683.23.06335-4. PMID: 37310157
Inconvenient Truths About Human Longevity.
Olshansky SJ, Carnes BA
J Gerontol A Biol Sci Med Sci 2019 Nov 13;74(Suppl_1):S7-S12. doi: 10.1093/gerona/glz098. PMID: 31001621
Rapid evolution of the cerebellum in humans and other great apes.
Barton RA, Venditti C
Curr Biol 2014 Oct 20;24(20):2440-4. Epub 2014 Oct 2 doi: 10.1016/j.cub.2014.08.056. PMID: 25283776
Morbidity from episiotomy.
Islam A, Hanif A, Ehsan A, Arif S, Niazi SK, Niazi AK
J Pak Med Assoc 2013 Jun;63(6):696-701. PMID: 23901667
The crowning achievement: getting to the root of the problem.
Fong HK, Foster BL, Popowics TE, Somerman MJ
J Dent Educ 2005 May;69(5):555-70. PMID: 15897336

Clinical prediction guides

Inconvenient Truths About Human Longevity.
Olshansky SJ, Carnes BA
J Gerontol A Biol Sci Med Sci 2019 Nov 13;74(Suppl_1):S7-S12. doi: 10.1093/gerona/glz098. PMID: 31001621
The optimal angle of the mediolateral episiotomy at crowning of the head during labor.
Ginath S, Elyashiv O, Weiner E, Sagiv R, Bar J, Menczer J, Kovo M, Condrea A
Int Urogynecol J 2017 Dec;28(12):1795-1799. Epub 2017 May 5 doi: 10.1007/s00192-017-3349-9. PMID: 28477150
Timing of episiotomy and outcome of a non-instrumental vaginal delivery.
Rusavy Z, Karbanova J, Kalis V
Acta Obstet Gynecol Scand 2016 Feb;95(2):190-6. Epub 2015 Dec 8 doi: 10.1111/aogs.12814. PMID: 26563626
Rapid evolution of the cerebellum in humans and other great apes.
Barton RA, Venditti C
Curr Biol 2014 Oct 20;24(20):2440-4. Epub 2014 Oct 2 doi: 10.1016/j.cub.2014.08.056. PMID: 25283776
The crowning achievement: getting to the root of the problem.
Fong HK, Foster BL, Popowics TE, Somerman MJ
J Dent Educ 2005 May;69(5):555-70. PMID: 15897336

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