- breech - a complex of therapeutic exercises help
- What could be the presentation?
breech delivery - is a condition in which a child in the womb before birth is not the head and the pelvis down.At the same time one or both of his legs can be bent;often breech both legs extended.It is associated with increased risk of birth defects and death of the mother and child during childbirth.Currently, however, the mortality associated with breech reduced.The most secure when it is considered a caesarean section, but there is a high probability of having a healthy baby naturally.
28 weeks pregnant breech presentation occurs in approximately 28% of children;on the day of birth - at 3-4%.
The following factors increase the chance of breech:
- Abnormalities of the uterus (eg, two-horned uterus horned uterus: what you need to know about pregnancy and childbirth or mat with a partition), andcancers of the uterus
- placenta previa
- Anomalies structure of the pelvis
- Maternal smoking
- fetal malformations Fetal development - week after week (eg, hydrocephalus)
- Multiple pregnancy
- or oligohydramnios Polyhydramnios
- Low birth weight (prematurity or intrauterine growth retardation)
- breech during previous pregnancies.
- Mechanical risk factors breech is approximately 7-15%.
to 32-35 weeks of pregnancy, breech presentation diagnosed in most cases has no clinical significance.
Treatment In uncomplicated breech women are advised to undergo the procedure, called external version on the head (ECV) - if there are no contraindications.
- ECV reduces the chance of breech at delivery, and hence the need to carry out a caesarean section.At the same time, after successful ECV obstetric interventions during labor is required more frequently than in spontaneous cephalic presentation.
- ECV is successful in 30-80% of cases.It depends generally on the presence of various underlying diseases and abnormalities in the mother.
- adverse outcomes when ECV is rare.Among the related complications: placental abruption, uterine rupture and haemorrhage in the mother and / or fetus.However, the risk of fetal death due to complications such ECV is increased only slightly.
- ECV proposed to do 36 weeks of pregnancy were not previously parous women, and at 37 weeks - those who have had to bear.Sometimes when doing the procedure term pregnancy, and even at an early stage of labor.
- Contra ECV (eg, the presence of other indications for cesarean delivery, antepartum haemorrhage during the last week, abnormalities in the results of CTG (KTG), anomalies in the structure of the uterus, rupture of membranes) are found, on average, 4% of womenbreech.
- Spontaneous reversion to breech presentation after successful ECV is observed in less than 5% of cases.
- Before the procedure the doctor should inform the patient that sometimes passes ECV painful;at the request of the woman need to interrupt the process.In severe pain during ECV complains about 5% of patients.
- Tocolysis (the use of drugs that reduce the tone of the uterus) increases the likelihood of success of ECV.It can be used if the procedure without drugs fails.
One of the most important decisions for women with breech and her doctor - to carry out a caesarean section or try to give birth naturally.Please note the following:
- Planned caesarean section reduces the risk of fetal death, and also the chance of developing serious complications related to birth traumas Birth injuries - than they threaten your child? .
- Conventional breech presentation, as a rule, do not have a significant impact on child health in the long term.
- Since caesarean section is a slight increase in the risk of serious birth complications, compared with vaginal delivery.
- after cesarean increases the likelihood that you will need a Caesarean section and in subsequent pregnancies.