Doing a somersault, or how to turn a child in a breech presentation. The position of the fetus in the uterus: what every mother needs to know What to do if the fetus lies

Non-standard presentation of the baby is a common occurrence modern world. It happens that in the last weeks the child himself turns over into the correct position. What to do if it happened that the child did not accept best pose to go out? This article will reveal the main questions on the topic, the answers to which were given by practicing doctors.

Types of position of the child in the uterus

In the womb, a baby can take any position:

1. Pelvic. Found in 2-3% of cases out of 100. Breech presentation is divided into 2 types: foot and buttock. With a foot, during childbirth, the baby’s legs may come out first, the doctor is obliged to support the fetus with his hand so that the pelvic part comes out first, then the birth process will be easier and safer. Breech presentation is dangerous because during childbirth the process of obtaining oxygen can slow down, you need to control the time of birth and the rate of appearance of crumbs from the womb. Giving birth in this arrangement is considered a difficult process, significant complications are possible for the woman in labor and for the baby. In this case, it is not necessary to resort to a caesarean section, you need to take into account the nuances: type of presentation, size, age of the mother, size of the pelvis, take into account a girl or a boy, since damage to the genitals is possible with such childbirth, and a previous pregnancy.
2. Oblique. This phenomenon appears with tumors in the uterus, excessive stretching (especially in those who have already given birth), with a large fetal weight(more than 4 kg), entwined umbilical cord. Natural childbirth in this state is contraindicated, an operation is required here. This is extremely rare, in about 0.2% of cases out of 100. A few weeks before childbirth, women with a transverse or diagonal position of the fetus should go to the hospital for preventive measures before surgery.

Incorrect presentation of the fetus always causes concern among doctors, as this may require an unscheduled operation.

What is the danger of the wrong position of the child

Head is the biggest part small body crumbs. And if it is in the main presentation before childbirth, then after the head comes out, the rest of the body easily passes through the birth canal. What if baby turned on side, and sits on the fifth point, then high risk of lack of oxygen in the blood and tissues, respiratory failure, dislocation of the leg, prolapse of the umbilical cord, underdevelopment of the joints. In addition, it is dangerous for the mother of the baby.

There may be ruptures of the genital organs, hematomas, weakness of the labor activity, in extremely difficult cases, it can come to the death of the mother or baby, but if you follow all the advice of the doctor and trust the specialists during the operation, this can be avoided.

Let's look at the risk ratio for misplaced baby as a percentage:

How to determine the incorrect position of the fetus

There is a lot of controversy on the net to actually independently determine the baby’s assumption. The obvious answer is that you should not take such actions. It's impossible to do it on your own you need to contact a specialist. If you have such a question, try to immediately contact your doctor. There are several ways to determine the location of the fetus:

1. Ultrasound procedure. A special ultrasound specifically confirms the position of the fetus, and is rarely wrong, this is the most accurate way to determine the presentation. The safety of the method is confirmed by the Ministry of Health and practitioners. In the first trimester, a transvaginal ultrasound is used to find the fetus inside, and on 2nd and 3rd trimester - abdominal, the device is in contact with the walls of the abdomen and is considered absolutely harmless.
2. Vaginal examination. It is carried out in the initial period of childbirth. An examination is carried out to make sure that the fetus has not entered the small pelvis, uterus dilated by 3-4 cm. In this position, the baby's shoulder, vertebrae, ribs, less often elbows, part of the arm may appear. If such parts of the body become visible, then there is no doubt in the transverse position of the fetus.
3. External examination by palpation through the walls of the abdomen. When feeling the abdomen, small parts of the body are difficult to distinguish, but the head is accurately determined on the right or left side. It is also possible to define the pelvic region. Really find the baby's heartbeat, and hear the beat frequency of the small motor. Significant difficulties in determining the position of the fetus can occur with multiple pregnancies, excessive uterine tone and polyhydramnios.

The oblique position of the fetus during pregnancy can be seen by the doctor with a competent examination of the patient.

Causes of the wrong position

Incorrect lying is caused by a number of reasons. First - excessive mobility of the child inside. As a result, extra intrauterine fluids, frail muscles of the abdominal part of the abdomen, a delay in the development of the baby for several weeks, high uterine tone, anomalies in the structure, and tumors may occur in the mother's body. internal organs.

There are reasons that do not belong to the medical definition. The wrong condition of the baby may occur, when the mother of the baby sleeps only on one side, even the way you fall asleep affects the location in the womb. Having such a tendency, it is better to turn on different sides before going to bed, lie on your back, on your stomach - this is more useful for early term pregnancy. Otherwise, surgery may be required. at the end of pregnancy.

Habits can change if you work on them, especially when it comes to the birth of a new person. Another reason is multiple pregnancy. If the mother is carrying twins, then competition appears already inside the abdomen. Each fetus wants to take the most comfortable place in a cramped space, so the fetus is located in any convenient position.

Important: neglecting the mandatory conditions for the birth of children with improper intrauterine placement, can cause surgical intervention by doctors, which is always difficult for the body of a young mother, because the birth itself is a huge stress and tremendous stress on the woman in labor.

Is it possible to change the position of the fetus

Change is real, there are several effective ways. Talking to the baby gives good results. The child loves to listen to stories and fairy tales, more talk with your hands towards your lower abdomen so that the child turns over in the right direction. Tell her that mom really wants the baby to be born healthy and for this you need to roll over.

Take advantage of your child's curiosity. Put a flashlight on your belly and the baby will begin to move and catch the light, or turn on pleasant music through the headphones and lower it in the right direction. The child craves communication since the womb, this is a chance that it is a sin not to take advantage of. It is important to pay attention to physical exercises.

Good for pregnancy yoga try the half bridge exercise. Lie on your back on a blanket, or mattress, much softer than a simple hard floor, and arch your back. First, try to be in this position minutes 3 then increase the load. A necessary factor will be a healthy and proper nutrition, walks in the park or light sports activities.

Other ways to change the position of the fetus:

1. Try to work out dancing, swimming, this will help the baby to take the correct position.
2. Follow the example of animals, this is absolutely serious! Have you seen how cats behave during pregnancy? They stand on their feet and stretch their back up and down, doctors advise these exercises for the correct position of the fetus.

It is also effective nice exercise, it must be performed lying on your back, arms extended along the body, and slowly lifting, lowering the pelvis down, you must breathe evenly and moderately.

Third exercise: lie down on your side, bend your knees, alternately changing sides, rolling over your back. By doing such exercises, you can help the unborn child to take the correct position before childbirth. Watch how the baby behaves when doing exercises, if he is actively moving or moving, then most likely he is changing his state.

Watch the video on the topic "How to determine the presentation of the fetus yourself":

The location of the fetus in the uterus is determined by its presentation and position. From these characteristics will depend on how exactly the baby will be born: by the method of uncomplicated independent childbirth - or by caesarean section.

What is the presentation of the fetus - types of presentation of the child in the uterus

The condition under consideration is the position in which the baby is on recent weeks gestation - or immediately before childbirth.

Often, an obstetrician-gynecologist can determine the presentation - or the position of the fetus - after the 32nd week of pregnancy. The thing is that at this stage of development, the fetus increases in size, and there is not enough space in the uterus for it to roll over freely.

Video: Position, presentation, position and view of the position of the fetus

Depending on which part of the body is located closer to the pelvis, there are two types of presentations:

1. Breech presentation

The infant is positioned longitudinally in the uterus with its legs/buttocks facing the pelvic outlet.

There are several types:

• Foot (extensor). The fetus rests with one or both legs against the entrance to the small pelvis.
• Gluteal (flexion). The baby's feet are practically on the same level with the head, and the legs themselves are extended along the body.
• Mixed.

Options for breech presentation of the fetus - leg extensor, gluteal flexion, mixed

2. Head presentation

The fetus is in a longitudinal position, its head is turned towards the entrance to the woman's small pelvis.

There are several options for the considered type of fetal presentation:

• Occipital. During labor, due to the deformation of the cervix, the back of the head appears first, which is turned forward.
• Anterior head (anteroparietal). The main emphasis at the exit is on a large fontanel. This makes childbirth more protracted, and also increases the risk of injury to the baby.
• Execution. The wire point at the time of labor activity is the forehead of the child. In this case, natural childbirth is impossible - surgical intervention should be performed.
• Facial. Often, with such a presentation, doctors prepare a woman in labor for, although natural delivery is also possible. The child comes out of the small pelvis with the back of the head, and the chin serves as the leading point.

Head presentation of the fetus is diagnosed in 96-97% of cases

Types of position of the child in the uterus

When determining the placement of the fetus in the uterus, use two basic concepts:

1. Axis (length) of the uterus- a straight line, conditionally passing through the bottom and cervix.
2. fetal axis- a transverse line that stretches along the back from the back of the head to the coccyx.

When determining the position of the fetus, the direction of its axis in relation to the length is taken into account.

In the event that the axes of the baby and uterus coincide, there is a place to be longitudinal position of the fetus. talking in simple words if the expectant mother will stand, the fetus will also be located vertically. The head should ideally be aimed towards the exit from the small pelvis, and the pelvis towards the uterine fundus.

The position of the fetus is considered incorrect if it:

• transverse. The infant's head and pelvic bone are palpated in the lateral sections of the uterus. Diagnostic measures confirm that the axis of the uterus and fetus are at an angle of 90 degrees with respect to each other.
• Oblique. The angle between the uterine axis and the fetal axis is 45 degrees. In some cases, this value may increase.

Causes of the incorrect position of the child in the uterus and pathological presentation

There may be several reasons for the pathological phenomena under consideration, but all of them are conditionally divided into 2 large groups:

1. Those caused by errors in the structure of the uterus

2. Pathological phenomena that provoke an increase or decrease in the motor activity of the fetus:

• Errors in the development of the fetus. Absence of the brain, dropsy of the brain can lead to the fact that the baby takes an oblique position in the womb.
• The presence of several fetuses in the uterus. This phenomenon significantly limits the mobility of babies.
• Hypertension of the uterus. Similar pathological condition can be triggered by curettage of the uterus, inflammation of the cervix / body of the uterus, abortion. In addition, frequent overwork, stress, neurosis, etc. can lead to an increase in the tone of the uterus.
• Much or little water. In the first case, the uterus increases in parameters, which creates conditions for active movements for the baby. If the amniotic fluid is below normal, the child is simply not able to take the correct position.
• The weight of the fetus is very large (from 4 kg and above) or very small. In the latter case, the child is able to freely and regularly change position in the uterine cavity.
• Weakness of the abdominal muscles. This is especially true for women who have a history of 4 births or more. Muscles lose their elasticity and are not able to restrain the movements of the fetus.

According to the observations, gynecologists-obstetricians note a hereditary factor in the pathological presentation or incorrect placement of the child in the uterus.

Why is the wrong position of the child in the uterus dangerous?

With a non-standard fetal position in the uterine cavity, a favorable independent resolution of childbirth is extremely unlikely.

Often, labor activity is accompanied by the following negative phenomena:

1. Premature release of amniotic fluid. Due to the lack of pressure on the entrance to the small pelvis.
2. Inflammatory processes in the walls of the fetal bladder, as well as infection of the amniotic fluid. With the penetration of harmful microorganisms into the uterine cavity, peritonitis and sepsis may develop.
3. Acute fetal oxygen deficiency.
4. Violation of the integrity of the uterus. Earlier discharge of amniotic fluid can be the result of a strong indentation of the shoulder girdle into the entrance to the small pelvis. Against the background of active contractions of the uterus, its lower section is stretched, and can break.
5. Prolapse of small parts of the child's body with the rapid discharge of amniotic fluid. When the umbilical cord is clamped, serious circulatory failures occur, and childbirth, as a rule, is fatal for the baby.
6. Injury to a child during childbirth.

With a strong contraction of the uterus and the transverse position of the fetus, it is possible to bend it in half. In this case, the sternum comes out first, then the stomach with the head pressed against it. The lower limbs come out last. Such a development of events often ends in the death of the baby.

Signs and symptoms of malpresentation or position of the fetus in the uterus - can you notice it yourself?

Self-determination of the position of the fetus inside the uterus is a difficult task, and not always effective. Better for similar purposes contact an appropriate specialist and/or undergo an ultrasound examination.

Obstetrician-gynecologists, as a preliminary diagnosis, feel the belly of the future woman in labor.

• If in the upper part it is soft and inactive, and a dense, rounded and movable part is felt below, this indicates a longitudinal presentation of the fetus.
• If palpation of the upper and lower sections of the uterus confirms the emptiness of the uterine fundus, and the head and buttocks of the baby are palpated in its lateral sections, the position of the fetus is transverse.
• With an oblique location of the baby in the uterine cavity, its head (dense part) will be localized in the iliac zone.

Diagnosis of the position of the fetus in the uterus

Diagnostic measures to determine the posture of the fetus are complex. They consist of several procedures, which carried out not earlier than on the 34th week of gestation:

• External inspection. At normal course pregnancy, the uterus should have an oval-elongated shape. If the fetus is placed incorrectly, the abdomen will visually appear obliquely stretched (oblique position of the child) or transversely stretched (transverse position of the baby). If the baby’s position is incorrect, the uterus is spherical, not oval, and the bottom of the uterus is not high enough.
• Internal inspection. It is informative only after the discharge of water and the opening of the uterine os by several centimeters. It is necessary to conduct vaginal examinations in such cases very carefully - with the transverse placement of the fetus in the uterine cavity, the handle, leg or umbilical loop may fall out. If the fetus is turned with its buttocks towards the entrance to the small pelvis, the obstetrician, upon examination, will be able to examine the coccyx, sacrum, and also the baby's feet.
• Palpation of the abdomen. The details of this procedure were described in the previous section. At this stage, the doctor also determines the fetal heartbeat. With a longitudinal arrangement, it is palpable in the right / left part of the uterus.
• Ultrasound procedure. Determines the pose of the fetus with 100 percent accuracy.

Features of childbirth with incorrect presentation and position of the fetus in the uterus

Independent childbirth with an incorrect fetal position is possible with a combined external-internal rotation.

The obstetric situation should be uncomplicated, which includes the following conditions:

1. The uterus should open completely.
2. The woman in labor agrees to such a procedure.
3. A catheter is inserted into the bladder.
4. The fruit is not too large in size and can be expanded.
5. Pregnancy is singleton.
6. There are no pathologies on the part of the future mother and baby.

Surgical delivery with oblique / transverse placement of the fetus before the onset of contractions is carried out under the following pathological conditions:

• Early discharge of amniotic fluid.
• Overlapping a child.
• placenta previa.
• Oxygen starvation of the fetus.

Usually, towards the end of pregnancy, the fetus is located in the uterus head down (head presentation), rarely the leg or buttocks (pelvic), and even less often when the fetus is located across (transverse).

Breech birth is considered an unusual situation, and the doctor is required to determine whether the situation would be risky. In the head office, they follow the usual program. Butt forwards also proceed according to a natural scenario, but they require great patience and skill from the doctor, from mommy - composure, from the baby - absolute health and resilience.

Doctors decide in favor of the usual scenario if:

• the baby appears on time and is healthy;
• its estimated weight is medium (for large and small children, natural childbirth is unsafe);
• the umbilical cord does not wrap around the neck (otherwise hypoxia may begin - a lack of oxygen);
• if there are no abnormalities in the structure of the uterus of a pregnant woman;
• the expectant mother is healthy;
• normal size of the pelvis;
• if the woman had no problems during pregnancy and she is not more than thirty years old;
• childbirth develops without failures.

It becomes clear the location of the fetus in the seventh month of pregnancy, during the probing of the abdomen by the doctor. He must confirm his conclusions with the results of an ultrasound examination and examination through the vagina.

The child is sitting. It is possible to recognize the breech presentation of the child, starting from the 32nd week: the hard head of the child is groped in the upper part of the uterus, in the lower part - the soft buttocks.

The baby is lying down. By probing the belly of the future mother, the doctor can "detect" the buttocks and the head of the little sly on the sides. This position can be determined from the middle of pregnancy, from about the 20th week. You can try to correct this situation by resorting to the help of a special exercise, but this should be done only from the 31st week.

You need to lie down on a hard surface, first turn on your left side, and then on your right side, and lie down in each of the positions for about ten minutes. It is worth doing this exercise three times in 3-4 sets and be sure to do it before meals. When the position of the fetus is corrected, the doctor advises wearing a bandage to fix the result.

Sometimes babies arrange a surprise for doctors and mothers, located in the uterus across or obliquely. There is a possibility that after the outflow of waters, by the beginning of childbirth, the fetus will still take the proper position. The only thing that is unknown is the location of the child (ass or head down).

If the baby was forced entanglement of the umbilical cord lie on the side, a septum in the uterus or the placenta is too low, the doctor will suggest sending the woman in labor for a caesarean section. In the old days, obstetricians tried to unfold such children, but this required great endurance and considerable skill. But also this small manipulation was unsafe for the child. There was no other way out, a caesarean section at that time was a very risky business.

But with the development of surgery, the advent of drugs and suture material, doctors have an excellent opportunity to preserve the health of both mom and baby. Therefore, the transverse position is not corrected today, but a caesarean section is performed. expectant mother.

Often yoga classes, a stand in the “birch” position help the child roll over. But due to the fact that the pregnant big weight the abdomen and the center of gravity is shifted, such exercises are best performed with someone's help. The best way is with the help of a yoga instructor.

Many pregnant women try to surround themselves with certain "signs" of happiness to give themselves confidence. At the same time, it is desirable that others do not guess what it is and why. A golden horseshoe pendant around the neck can become such a talisman. It will look to others as just a decoration. If a husband gives such an ornament, during labor it will give a feeling of the presence of the future dad nearby.

Of course, every mother wants that during pregnancy there are no deviations from the norm and her baby develops as it should. But women, especially those who have experienced pregnancy for the first time, very often have questions about the conclusions, since they practically understand nothing in medical terminology. Very often, the same problem occurs when the mother is informed about the location of the fetus in the uterus. When she sees the longitudinal position of the fetus in the conclusion from the ultrasound, she immediately has many questions. And due to the fact that very few young expectant mothers have knowledge in this area, doubts do not leave even when the doctor claims that everything is fine with the baby.

Therefore, it is very important to know how exactly the position of the baby in the womb will affect the birth. Most of all, this question is asked by women who are going to give birth for the first time. And how should one react correctly when it is written in the conclusion that the position of the fetus is longitudinal? In this case, you just need to be happy, because this is the most the best option the position of the child and he is the best for the birth to be completely successful.

The longitudinal position means that there is a straight line that runs exclusively along the child's spine. In addition, if there is also a head presentation, then there is absolutely no reason for panic. The baby lies in the best position, which means that childbirth will not be so painful.

It is also worth remembering that the longitudinal position of the fetus is the most common and occurs in about 96% of women. In the rest, the presentation of the fetus is pelvic. When this happens, the birth is initially considered pathological. But if, nevertheless, the position of the fetus is longitudinal and at the same time its dimensions are not large, and the mother’s pelvis allows the baby’s head to pass, then the birth will be natural. The child will move gradually through the birth canal and after the head appears, the rest of the body will also slip out.

But what to do if the position of the fetus is pelvic? Very rarely in such cases, doctors risk natural childbirth. Most often, in such cases, they prefer to do a caesarean section. Natural childbirth is very risky and should pass very quickly. Indeed, in such cases, every second is worth its weight in gold. In addition, after the birth of a child, an orthopedist should regularly monitor the development of the hip spine for a year in order to fully control the development of the hip spine. Also, another danger is bleeding, which can be very harmful for both the mother and the child.

How to change the incorrect position of the fetus during pregnancy

Also, if the axis of position is slightly shifted, then it is necessary to lie more on the side on which the fetal head is more tilted. Thus, you can try to change the situation at least a little, although these methods cannot guarantee one hundred percent occupation of the desired position by the child. When a certain result is fixed, then in order for the child not to turn back, it is necessary to use a bandage, which will help to fix the position of the fetus in the uterus.

But whatever the position of the child, modern medicine can help the child be born both naturally and surgically.

Childbirth in the breech presentation is often accompanied by complications, and in the transverse position, the crumbs have to go to. Luckily, malposition can be corrected if timely take up this important matter.

The position of the fetus in the uterus

Until the 30th week of pregnancy, the baby swims freely in amniotic fluid. And he obviously likes this job! He behaves actively, somersaults like a little dolphin. But by the 32nd week, babies grow up, accumulate muscle mass and, since there is almost no free space in the uterus, they usually take a position that is maintained until childbirth. Most of them literally stand on their heads - such a presentation is called head presentation. This is the norm, all other options are considered deviations from it. Is the baby placed in the uterus with the buttocks forward? It's about breech presentation. It is difficult, and often impossible, to be born in this way without medical care. Hippocrates believed that children come into this world by kicking off the bottom of the uterus with their feet. Now this reasoning looks naive: the “leg thrust” of the fetus does not participate in the mechanism of childbirth. The main problem is that the baby, born from the opposite end, is forced to follow the path of greatest resistance. Fortunately, at this stage of pregnancy, the baby is still able to change the position!

Tip: For the baby to take the right position in the uterus, do the Dikan exercise in the morning and then 2-3 more times during the day.

1. After making your morning toilet, lie on your right side and wait 10 minutes.
2. Roll over onto your left side and wait another 10 minutes. Repeat the flip a total of 6 times.

The baby does not like such gymnastics: in protest, he makes somersaults in his mother's tummy. Sometimes this happens almost the first time (will confirm the result ultrasound procedure). True, it is possible that the little stubborn one will again turn over with his buttocks down. Immediately put on supportive maternity underwear (should be worn from the 4th month) and a bandage to fix the stomach and force the baby to keep the head presentation.

Particularly comfortable is the model with a supportive belt, reminiscent of an elastic hood, where a rounded tummy fits comfortably. Due to its features, such a bandage supports it without squeezing, and properly stretches as the baby grows. Put on underwear and a bandage in the morning without getting out of bed.

Sex in the last months of pregnancy

From the 33rd week, 8 weeks before the birth, you need to give up sex. The child should not be disturbed: otherwise, he may turn around and take another position, uncomfortable for childbirth.

Gymnastics for pregnant women in the third trimester

The Dikan exercise loses its meaning after the 34-35th week, when the grown-up child densely fills the space inside the uterus. It is already much more difficult for him to roll over from his legs to his head, therefore, exercises are needed much more active, for example, Grishchenko's gymnastics, which is specially taught to expectant mothers in childbirth preparation centers. It gives effect from the 34th to the 38th week. If the baby has not changed the presentation, the last resort remains - the external rotation of the fetus on the head. It will be performed on the 35-37th week by a doctor in the maternity hospital (you will have to go to it in advance). By acting on your stomach with his hands, the doctor will try to turn the baby in the right direction. True, this method is not always resorted to - it has many contraindications, for example, late toxicosis (preeclampsia), threat, little or polyhydramnios, a scar on the uterus or unsuccessful (to its front wall) attachment of the placenta, conception in vitro, age over thirty, if this is the first pregnancy ... No matter how hard doctors and mothers try to correct the incorrect position of the fetus, 4% of newborns are still born in a breech presentation.

If everything goes to this, you should not wind yourself up in advance. Childbirth can proceed quite normally if the mother is young and healthy, the pelvis is wide enough, and the fetus is not too large. However, even in the most favorable situation, no one will undertake to predict the final result - too many unforeseen accidents lie in wait for a baby who decides to come into this world in a non-standard way! Fortunately, the possibilities of modern medicine make it possible to minimize the risk for mother and child. The main thing is to calculate all the options in advance and choose the best method of delivery for abnormal position of the fetus.

Birth in breech presentation

At the beginning, when contractions begin, and the cervix gradually opens, childbirth in the breech presentation provokes premature. Serving as a natural shock absorber, they help the child to more easily endure the period of disclosure and actively participate in it, acting as a hydraulic wedge that expands the cervix. But this is the case if the baby's head plays the role of a "piston" for such a wedge. His legs and buttocks are so small that there is no “piston” of them: too much water rushes into the lower part of the uterus with each contraction and the bladder breaks ahead of time. Then the birth is delayed, the child suffers from congestion, and the risk of infection increases. But the worst thing is that under the pressure of waters that do not rush in time, the umbilical cord can fall out. With each contraction, blood circulation in her vessels will be interrupted, which is fraught with oxygen starvation- fetal asphyxia. The doctor will try to thread the cord loop back. If this fails, the only way to save the baby is to perform an urgent caesarean section. In the second stage of childbirth, when contractions drive the baby out, the main difficulty is due to the fact that the largest part of the child's body - the head - is born last. The first to appear are miniature buttocks and legs, which are not able to expand the birth canal sufficiently to allow the shoulders and head to pass freely. This is where the problems start!

The most unpleasant thing is when the head, which is supposed to remain in a bent position, overextends during childbirth and the chin gets stuck under the pubic joint - neither here nor there! The baby blocks his oxygen by pinching his head at the exit of the birth canal vessels of the umbilical cord. The doctors have only 4 minutes to save the child!

Another possible complication- throwing back the handles: instead of remaining pressed to the body of the baby, they can be located on his face, back of the head or on the side of the head, and it gets stuck in the birth canal, blocking the blood flow in the umbilical cord. That is why, taking such births, doctors prepare for any surprises, up to emergency caesarean. Maybe it's better not to risk the life of a child, but to immediately tune in to a planned operation? To weigh all the pros and cons, doctors need to observe you, assess the degree of readiness of the body for childbirth, so you will have to go to the hospital 2 weeks before the end of pregnancy. It is very difficult to come to an agreement if mommy is a supporter natural childbirth at any cost, and the doctor insists on caesarean section. The last word still belongs to him - the specialist knows better! Persuading you to have an operation, he takes into account all the nuances up to the sex of the child. If a girl is expected - give birth to health, if a boy - it is better to stop at a cesarean to avoid injury to the testicles.

Natural birth with breech presentation

So that, despite the breech presentation, the baby can be born naturally, it is necessary to behave correctly during the birth marathon.

1. From the very beginning of the contractions, do not get out of bed! While you are lying down, there is less risk that the water will break prematurely and the umbilical cord will fall out. No matter how long you have to stay in bed, do not try to leave it until you are allowed to.
2. With breech presentation, weakness of labor activity is often found. Delaying childbirth is harmful for the baby: the uterus needs to be stimulated! Some mothers object to injections, believing that everything should happen naturally. But the situation is extraordinary.
3. To make it easier for the child to pass the birth canal, and the mother does not have a uterine rupture, the doctor can resort to a perineal incision and inject a special drug: it will prevent cervical spasm when the head passes through it.
4. The most crucial moment comes after the baby has come out waist-deep. This means that the head entered the pelvis and squeezed the umbilical cord. Now you can't delay! If the birth does not end in 2-3 attempts, the doctor and midwife use special techniques (manual aid) to quickly release the baby's shoulders and head.

How to determine the position of the fetus?

transverse and oblique position of the fetus complicates childbirth to a greater extent than breech presentation. The tactic here is to identify the problem early and force fetus from a wrong position turn around the right way. To suspect something was wrong, you do not need to be a midwife: just look at the stomach in the mirror. Take a closer look at him from the 28th week. He is right for you oval shape- resembles a cucumber, elongated along the axis of the body? Wonderful! Is it too low and stretched out more than it is up? This happens with a transverse position, and with an oblique position, the stomach seems somehow wrong, asymmetrical. To force a slanting baby to change its position, you should sleep and rest on the side where the large underlying part (head, buttocks) is located. Suppose the head is located in the left iliac region (this will be determined by the doctor during the examination, and the results of the examination will be confirmed by ultrasound) - lie only on your left side! If at oblique position the buttocks are placed below, it is better to turn to the pelvic end. The transition from an oblique position to a breech presentation in this case is clearly seen as a great boon, especially since the child may well then turn his head down.

Transfer baby to longitudinal position sometimes Dikan's special exercises help. If all else fails, you will have to go to the hospital at the 35-36th week. Specialists will try to perform an external rotation of the fetus manually (through the abdomen), and if there is no result, they will make an internal rotation during childbirth. An important condition: the fetal bladder should not burst ahead of time. Ideally, until the cervix is ​​fully dilated, through which, in fact, such a turn is made. To prevent this from happening, a rubber can - a colpeirinter - will be inserted into the vagina of the expectant mother and she will be forbidden to get up. Well, if the internal rotation is impossible, there is only one way out - a caesarean section!

Causes of malposition of the fetus

The child can take an oblique and transverse position or breech presentation, if:

• frequent pregnancies;
• there is uterine fibroids;
• pelvic bones or uterus irregularly shaped (for example, in the form of a saddle);
• the placenta is present;
• the pelvis is too narrow;
• pregnancy is accompanied by multiple pregnancy, many or;
• the fetus has a very short umbilical cord;
• childbirth began prematurely.