Breech presentation - how to help a woman in labor?
breech presentation usually guards and a woman, and an obstetrician-gynecologist who is watching her.Therefore, often waiting until the end of pregnancy, the baby will turn and take the correct position or trying to help him turn over.If this does not happen, then there is no tragedy in this, simply by taking a birth fetal position will be considered.
fetal presentation is determined by the nature of the presenting part, ie the part of the fetus, which is directly above the entrance to the pelvis.When the correct position of the fetus presentation can be either the head or pelvis.The options are occipital cephalic presentation (in most cases), perednegolovnoe, frontal and facial.The options are breech breech, buttock-Foot (complete or incomplete) and foot (complete or incomplete).
If malposition presenting part is not, it may occur during childbirth, when the entrance to the basin is suitable shoulder of the fetus or a side handle drops and so on.
Breech presentation, options and the reasons
In the first half of pregnancy, the baby is usually head up and down the buttocks, about the 32nd week of pregnancy, there is a revolution - the baby turns head down.But some children (3-4%) are not rotated.This baby's legs can be bent only in the hips and stretched along the body (purely breech presentation) or in the hip and knee joints (mixed breech presentation).
reason that the child can not turn over upside down, often narrowing and irregular shape of the pelvis, uterine malformations, uterine fibroids, congenital malformationsof the fetus, placenta previa, impaired uterine tone due to the large number of births, the location in the uterus a few fruits, excessive mobility of the fetus in polyhydramnios, and so on.
If breech presentation is usually marked by high standing uterus, when probing head is on top, and buttocks - the bottom.Breech presentation is well determined by ultrasound.
In some cases, the fetus can turn upside down just before the birth.But sometimes this change helps him carry out an obstetrician-gynecologist with the help of external cephalic for turning breech in the head.For this turn from a doctor is required experience and excellent knowledge of this technique, since the rotation is not secure.
complications that may arise in the course of external rotation of the fetus - it's premature birth, placental abruption, cord compression or wound around the neck of the fetus.In view of the rather severe complications such upheaval is rare, but expanding the indications for cesarean section, as statistically confirmed that the operation a child who is in the breech position, injured less.
How is natural childbirth when breech delivery
When natural childbirth every movement of the fetus taken to relate to the next plane of the pelvis: the entrance to the basin, the wide and narrow parts of the pelvic cavity, leaving the pelvis.The fetus begins to move through the birth canal under the action of intrauterine pressure, contraction of the muscles of the pelvic floor muscles and the resistance of certain parts of the fruit.
first fetal buttocks move from a broad to a narrow part of the pelvis (the fruit is rotated so that the transverse dimension of the buttocks coincided with the direct size of the pelvis).First out front buttock, lumbar flexion occurs then the fruit that helps the rear exit buttocks.The next point - the establishment of a coat hanger in the forward rate of exit from the pelvis, thus goes back to the side and front shoulder comes out of the pelvis, the spine bends and allows the shoulder to go back.Then head rotates anterior neck, bends, turns and again is born: first the chin, then the mouth, nose, crown and nape.
Help in childbirth giving birth to breech presentation
During the opening of the birth canal is necessarily spent prevent premature rupture of the membranes, so giving birth is assigned bed rest.Home obstetric care during the period of the expulsion of the fetus is to prevent compression of the umbilical cord after birth, lower body, which turned the baby's body, repeating its natural motion and preventing the possible obstacles in his path.
during childbirth may occur following complications: delayed rupture of membranes, various anomalies (irregularities) labor, drawing back the handles, prolapsed cord, or small parts of the fetus, the uterus muscle spasm in place of an exit of the fetus from the compression of the torso or the neck of the fetus, a variety of injuries of softtissue, the brain and the spinal cord of fetal asphyxia (lack of air) of the fetus.
To correct all these complications developed special techniques, in addition, if the life of a woman or child in danger, the caesarean section is performed - dissection of the anterior abdominal wall and the wall of the uterus with extraction of the fetus.
Caesarean section is performed in cases where the woman does not want to risk (for example, she had been waiting for this child, or she had a stillbirth, etc.) or it suffers some gynecological diseases, such as uterine fibroids Uterine fibroids - when the operation is necessary? , a narrow pelvis.The indications for cesarean section may be toxicosis second half of pregnancy, prolonged pregnancy, first child over the age of 30 years, a large fruit, placenta previa, and so on.
Prevention of breech presentation is a special physiotherapy, which is held throughout the pregnancy up to 35 weeks.