Pelvic Presentation Of The Fetus
It is believed that physiologically normal location of the fetus in the womb should be with the child to have the head down, which should be located above the vagina, that is, during birth is head must first pass through the birth canal. But the position of the fetus is not always right. In about three percent of pregnancies, the fetus gets pelvic presentation, that is, it is located with one’s buttocks down.
Causes of pelvic presentation
- Polyhydramnios and high activity of the fetus.
- The presence of multiple pregnancy.
- Preterm pregnancy.
- A narrow pelvis of the mother.
- Placenta previa.
- All sorts of anomalies in the development of fetus.
- The anomalies of the uterus.
- Low tone of the uterus, which affects the process of correcting the location of the fetus in it.
Types of pelvic presentation
There are several options for the location of the fetus in the uterus:
- Breech presentation that is when above the vagina there are fetal buttocks, and legs stretched along the body.
- Foot previa - the legs are above the vagina.
- Mixed presentation - buttocks are above the vagina along with one or two legs.
- Knee presentation - very rare, and the baby is "sitting on bent knees", towards the pelvis of the mother.
Specialties of pregnancy with pelvic presentation
Pregnancy during pelvic presentation is not different from the normal one, it passes just well, and the woman alone can not determine fetal presentation. If after 32 weeks one was diagnosed pelvic position, the doctor may recommend a set of physical exercises that help to make the correct position of the fetus. After about a week or two of the exercises, the fetus can take its normal position if it did not happen until 37-38 weeks, delivery will take place with this misposition.
Specialties of birth with pelvic presentation
Method of resolving the birth with pelvic presentation is selected in the maternity ward, which a womanis offered to stay at a week before the expected date of childbirth. When choosing a birth naturally or by Caesarean section, doctors evaluate the following parameters:
- Age of a mother (if the first birth after is after the woman is 30 years old, it aggravates the time).
- Specialties of previous pregnancies.
- The presence of a natural birth in the past.
- Specialties of this course of pregnancy, presence of edema, blood pressure, kidney function, and more.
- Condition of the fetus - hypoxia and so on.
- The weight of the fetus.
- The size of the pelvis of a pregnant woman.
- The readiness of the cervix to the generic activity.
- Type of presentation of the fetus.
Natural birth in case of pelvic presentation
More than eighty percent of cases of pelvic presentation end up with Caesarean section. If the doctor decides to conduct natural childbirth, in the first period of birthgiving process, the woman should be in a horizontal position to avoid complications, such as loss of the fetus or umbilical stem loops.
The second half of childbirth takes place under the close supervision of doctors and obstetric care. The main objective for this period is to keep the location of the child's legs stretched along the body and press the hands to baby's chest.
A characteristic feature of a childbirth with breech presentation is that after the baby passes through the birth canal to the navel, the umbilical cord is clamped and hypoxia develops. It is essential that the full birth of the child lasts for not more than ten minutes, and it is better if the process takes up to five minutes, otherwise, anoxia may adversely affect the health of the baby.
To speed up the process of birth, incision of the perineum and induction of birth activity are almost always carried out.
After breech birth, the child requires special attention of neonatologist, as hypoxia may adversely affect the development of the nervous system, and there are cases of dislocation of the hip joints.
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