The location of the baby in the mother's tummy is an important factor in pregnancy. After all, the severity of childbirth, their course and the final result depend on the position of the fetus. If the baby is lying normally, then there should be no problems. Delivery in this case takes place naturally. If the position of the child is not what nature intended it to be, then a caesarean section is indispensable. Most likely, doctors will offer this option to a woman after an ultrasound scan performed in the last weeks of pregnancy. On the screen of the ultrasound diagnostic apparatus, the tiny body of the baby, its position, position are clearly visible. The appearance of the fetus will tell both the doctors and the woman the right decision.
Position and presentation: what's the difference?
Many expectant mothers often confuse the terms. Therefore, before talking about the specific positions of the fetus in the womb, it is necessary to explain the meaning of these words. So, first things first. The position of the fetus is the ratio of the axes of the uterus itself and the posture of the crumbs. When determining it, doctors are guided by a conditional line that runs from the head to the pelvis of the baby. If the axes coincide, then we can talk about the longitudinal position. When they are perpendicular to each other, the little one lies in a transverse position. Medium optionbetween the two above indicates an oblique position.
Previa is determined by the part of the body that is in close proximity to the neck. Accordingly, it is head or pelvic. With an oblique or transverse arrangement of the crumbs, the presentation cannot be fixed. In addition, the positions of the baby are determined based on the turn of the back of the child in relation to the sides of the uterus. If it faces the left wall, they speak of its first variety. The second position is called the reverse position. Sometimes the back is turned to the anterior or posterior wall of the uterus. In this case, we are talking about the type of fetus. The types of fetus are called respectively: anterior and posterior. By the way, up to the 34th week of pregnancy, the baby can change its position in the womb. After this period, the situation remains stable, since in a cramped space the baby can no longer “walk around”.
Head presentation
It dominates the overall statistics, as it is typical for approximately 95% of cases. Ideally, if the baby is located with the back of the head to the cervix. In this case, his chin is pressed to his chest, and his head is tilted. The first point that goes through the birth canal is a small fontanelle located at the junction of the parietal and posterior bones of the skull. In this case, two types of position of the crumbs are distinguished. So, 1 position of the fetus is called anterior occipital presentation. It is characterized by the fact that the baby's face is turned back (in relation to the mother's body). The posture is observed in 90% of pregnancies. It is the most optimal for a successful delivery.
There is also the 2nd position of the fetus, called the backoccipital presentation. In this case, in relation to the body of the parent, the face is turned forward. This greatly complicates the process. During childbirth, the baby can take the correct position, but this often takes a long time. The process may take longer.
Varieties of head presentation
This is not all forms of head presentation. Among other things, it is divided into the so-called extensor types, when the head of the little one is raised to a certain extent:
- Anterior head presentation. It has a small degree of extension. The leading point becomes a large fontanel, which is located at the junction of the frontal and parietal bones. It is possible to give birth naturally in this case, but the process is much more complicated and takes longer. The thing is that the head of the fetus enters the mother's pelvis with its largest part. In fact, this position of the crumbs is an indication for a caesarean section.
- Frontal position. Occurs in 0.5% of cases. If the size of the child is normal or large, its passage through the birth canal is impossible. Surgery is scheduled.
- Face presentation - the maximum degree of extension of the fetal head. This situation is recorded only in 0.05% of births. Natural birth of a baby is possible, but it can be traumatic for both mother and child.
Extension presentation of the baby is diagnosed by an obstetrician directly during childbirth using a vaginal examination.
Head presentationand fetal positions
Anterior occiput presentation in the first position of the baby is the most convenient option for normal childbirth. And fortunately, the most common. As already mentioned, in the first position, the baby is turned back to the left side of the uterus. In this situation, he moves "to the exit" with the smallest head diameter. That is, it can easily transform, stretch and narrow in order to pass through the birth canal more easily and quickly.
If the back of the baby is turned to the right side of the uterus, this is already occiput presentation in the second position. The situation is not so exemplary. In this case, the chances of the so-called clinically narrow pelvis syndrome increase. A woman has strong, but unproductive contractions that slow down sharply or stop altogether. In order for the baby to take a comfortable position - the first position, a woman needs to relax. So it will be easier for the baby to go down without colliding with the placenta if it is on the left or on the upper wall. The doctor will tell you the correct positions that will help the baby rise in the womb, turning the head and face to the right, and the back to the left.
breech presentation
It occurs in 5% of cases. The position of the fetus in this case does not affect the birth process. Breech presentation varies:
- The first position of the fetus is legs forward. In this case, the limbs are born first. To avoid this, the obstetrician delays the birth of the baby: he prevents his free movement with his hand. The limbs do not fall out. Atthe little one has the opportunity to turn his buttocks forward. If this happens, childbirth will be less dangerous.
- The second position of the fetus in breech presentation is the breech position. It is more favorable for both the baby and his mother. Despite this, the breech presentation itself is unnatural. In this case, the doctor recommends a caesarean section to many expectant mothers in order to protect the woman in labor and her baby from unnecessary injuries and pain.
Is a caesarean necessary?
Breech presentation is not a direct indication for surgery. The position of the fetus in this case is an additional, and not the main factor influencing the decision of the medical staff. Doctors consider the situation as a whole, taking into account other points:
- The age of the future mother, the size of her pelvis.
- The course of a woman's previous pregnancies, especially childbirth.
- Baby size. With a breech presentation, a fetus whose weight exceeds 3.5 kilograms is already large. Under normal conditions, this figure is 4,000 kg.
- Baby gender. Oddly enough, but it is very important. It turns out that breech presentation is not dangerous for girls. But in boys, genitals can be damaged during childbirth.
What to do in this situation?
If the ultrasound showed breech presentation, before the 34th week, the woman is able to change the situation. Having learned about the wrong position of the fetus, she is obliged to perform some exercises:
- It is necessary to lie on the right side and hold in this positionabout 10 minutes, then quickly turn to the left side. The exercise must be repeated 4 times in a row. It should be done several times a day before meals.
- It is recommended to stand in the knee-elbow position once a day for 15 minutes.
Swimming in the pool contributes to the coup of the baby in the womb. Therefore, if you have the opportunity to buy a subscription, you need to use it. When the baby rolls over on his head, be sure to wear a bandage for several weeks to fix his position. If this does not happen, two weeks before the birth, the expectant mother is sent to the hospital. There, doctors decide how the process will go. By the way, earlier doctors tried to manually turn the baby over, massaging the pregnant belly. But then this method was abandoned due to the high risk of complications: premature birth, placental abruption, impaired condition of the baby.
Oblique or transverse arrangement
In this situation, it is impossible to determine the presentation of the fetus. The position is a direct indication for a caesarean section. An oblique or transverse position of the baby in the womb occurs in 0.4% of cases. And if earlier, during childbirth, doctors tried to grab the baby by the leg and turn it over, today this method is not used. The technique turned out to be quite traumatic for both the baby and his mother. Sometimes a coup is performed during the delivery of twins. But only in the case when the first child has already been born, and the second at the same time suddenly took a transverse position.
The reasons for the oblique or transverse position of the fetus may be different. Among the main factors are tumors in the uterus, fibroids. Formations prevent the little one from lying in a natural position. Sometimes this happens when the child is very large or a short umbilical cord is wrapped around his neck: it restricts his movements. Another reason is the numerous births of a woman when her uterus suffered from numerous sprains. With an oblique or transverse position, a woman needs to perform all the exercises as with a breech presentation. In this case, it is also recommended to lie more time on the side towards which the back of the crumbs is turned. The woman is hospitalized 3 weeks before the expected birth. And if the situation has not changed, she is being prepared for surgery.
Fetal position with twins
The position and type of the fetus are established during routine ultrasound diagnostics. Sometimes during such research, future parents will learn about the surprise prepared for them by nature: they will have twins! After the euphoria, they begin to wonder if natural delivery is possible in this situation. Of course, this is quite realistic, but only in two cases: if both babies are in head presentation or the baby that is closer to the cervix has this position, and the other is located with the buttocks forward. When the leading baby has a "pelvic position", a cesarean is recommended. The thing is that during the birth of the buttocks of the firstborn, children in the womb can catch on their heads, which is fraught with injuries. It is clear that for oblique orthe transverse position of surgical intervention cannot be avoided. And even if the twins in the womb are in the correct position, the decision on the method of delivery is made by the medical staff, taking into account many factors.
