What does head presentation mean. Fetal position: longitudinal presentation head what is characterized by

The position of the fetus is the ratio of its axis to the axis of the uterus. It can be longitudinal, transverse or oblique. Up to 34 weeks, the position of the fetus inside changes, but after this period it becomes stable.

Presentation shows which part of the fetus is located above the exit from the uterus. Experts determine this parameter from 28 weeks. In a normal pregnancy, the baby is in occipital presentation.

Fetal position

Not correct position- a phenomenon when the axis of the fetus does not coincide with the axis of the uterus. Allocate oblique and transverse position. With this placement, the presenting part is absent in the womb. Natural childbirth in this case is impossible, if a woman has contractions, there is a high risk of effusion amniotic fluid and fetal hypoxia. Malposition occurs in 0.2-0.4% of all pregnancies. provoke this phenomenon may:

Multiple pregnancy.
Polyhydramnios.
Narrow pelvis.
Decreased tone of the uterus.
Flabby muscles of the anterior abdominal wall.

With normal development, the fetus should occupy a longitudinal position in the fetal position - the arms are crossed on the chest, the legs are pulled up to the stomach and pressed. Allocate the following types provisions:

Longitudinal - the axis of the fetus and uterus coincide.
Oblique - the axis of the uterus and fetus intersect at an acute angle.
Transverse - the axis of the uterus and the fetus intersect at a right angle.

With an oblique and transverse position, the child cannot be born naturally. When leaving the pelvis, the fetus can receive serious injuries that lead to disability and even death. In a transverse position, a woman at 37 weeks of gestation is hospitalized and C-section. With oblique - for some time they try to turn the fetus over. If the child does not take a longitudinal position, surgical intervention is performed.

Fetal presentation

There are two types of presentation: pelvic and head. If a woman is diagnosed breech presentation, then from 32 weeks she is recommended to perform special exercises or is sent for an obstetric coup.

At 38-39 weeks of pregnancy, a woman should go to the hospital. It determines how the birth will take place. The doctor needs to assess in advance the size of the fetus, pelvis, the age of the mother and the readiness of her body for childbirth. Breech presentation is not always an absolute indication for caesarean section, however, in the presence of complicating factors, another delivery option is not considered.

Breech presentation of the fetus

Breech presentation - the location of the fetus in the womb, when his buttocks or legs are above the exit to the small pelvis. Pregnancy with this pathology proceeds in conditions of constant threat of interruption, during childbirth there is a high risk of fetal hypoxia and serious injury. Diagnosis takes place during vaginal and external examination, dopplerography, echography and CTG. You can change the position of the fetus with special exercises or outside coup.

Among the causes of breech presentation are:

Much or little water.
Narrow pelvis in mother.
Multiple pregnancy.
Excessive activity of the fetus.
Placenta previa.
Pathology of the uterus.
Anomalies in the development of the fetus.

There is a risk in breech presentation spontaneous interruption. This situation negatively affects the development of the endocrine and nervous systems child. Starting from 33-36 weeks, the development of the medulla oblongata slows down - this leads to perivascular and pericellular edema. To minimize Negative influence, the pituitary gland of the child begins to work more actively, which depletes the cortical layer of the adrenal glands and slows down the development of immunity.

Breech presentation can be breech and foot.

Gluteal - the legs are extended along the body, the head is directed upwards.
Foot - one or two legs of the child are located above the entrance to the small pelvis.
Buttock-leg - both legs and buttocks are located above the bosom.

With the gluteal secrete:

Incomplete - the buttocks of the child are located above the entrance to the small pelvis, the legs are extended along the body.
Mixed - both legs and buttocks are above the exit from the uterus.

Foot presentation is also of several types:

Incomplete - one leg of the child is completely bent, the other is unbent and looks into the mother's pelvis.
Complete - legs not bent at the knees are above the bosom.
Knee - the knees of the child are above the entrance to the uterus.

The diagnosis of "breech presentation" is made after 32 weeks of pregnancy. Due to the fact that the baby is constantly moving in the womb, he can take the correct position for childbirth. This pathology can also be recognized at 20-22 weeks with the help of ultrasound. Such a study helps the doctor determine how the back, sacrum, interquarter line of the fetus are located, and assess the degree of bending of its head.

Birth in breech presentation

Women at 38-39 weeks should go to the hospital. There is held full examination, which helps determine how the birth will take place. Also, the specialist needs to assess the condition of the expectant mother, the duration of her pregnancy, the ratio of the size of the fetus and pelvis. Natural childbirth is indicated only with normal sizes of the pelvis and fetus, good condition of the birth canal, bent or slightly unbent head of the child, with mixed or purely breech presentation.

Among the absolute contraindications to natural childbirth, there are narrow pelvis, the presence of signs of hypoxia and impaired blood flow, Rh conflict, lipid metabolism disorders, the age of the woman in labor is over 30 years, the unpreparedness of the birth canal, overmaturity, foot presentation fetus and multiple pregnancy. In each individual case, the attending specialist chooses how the birth will be carried out, based on the individual characteristics of the mother and child.

Head presentation of the fetus

Head presentation of the fetus is the normal and most common position of the baby in the womb.

With it, the baby's head is located directly above the entrance to the small pelvis. Head presentation occurs in 97% of all pregnancies. The most optimal for natural childbirth is occipital, when the chin of the fetus is pressed to the legs. During the exit from the uterus, the back of the head appears first in this case.

With head presentation, the following types are distinguished:

Occipital - the forward-facing occiput first appears during childbirth.
Anterior parietal - the head is born first.
Frontal - during childbirth, the forehead of the baby is first shown.
Facial - when the head is first born with the back of the head.

At frontal presentation natural childbirth is rarely carried out, because it can provoke complications: rupture of the uterus or perineum, the formation of vaginal fistulas, fetal death.

With anterior parietal presentation, childbirth can take place both naturally and with the help of a caesarean section. However, in the first case, there is a high risk of injury to the baby, it is important to prevent fetal hypoxia. With facial presentation, the fetus exits the birth canal with the back of the head backwards. This is accompanied by maximum extension of the head. With facial presentation, a woman can give birth both naturally and with the help of surgery, exact way the doctor will determine.

Low fetal presentation

At 38 weeks of gestation, the fetus begins to descend little by little. However, sometimes the process begins at 20-36 weeks. low presentation- not a pathology, it does not affect the condition of the child or the expectant mother. This position of the fetus is individual feature female body. Despite the relative safety given state requires heightened attention, because it can provoke premature birth. With him, a woman will have to wear a prenatal bandage and completely abandon lifting weights and walking up stairs.

Speaking about the medical literature, one can recall many examples when childbirth ended in the death of the mother and her unborn child. One of the reasons high level mortality in childbirth in the 17th-19th century were difficult births, provoked by the transverse position of the fetus. Today, such a complication of pregnancy, although it remains a danger to the life of the child and mother, but the risk of death of both participants in childbirth has significantly decreased. The incorrect position of the fetus, including the transverse one, occurs in 1 case per 200 cases of childbirth, in percentage terms it is 0.5-0.7%. It is characteristic that situations with a violation of the normal position of the fetus in the uterus occur more often in multiparous women (more often 10 times) than in women with the first birth.

Some terminology

Based on the data on the position of the fetus in the uterus, the tactics of childbirth are determined. To understand the terms, you need to understand the following concepts:

axis of the uterus - a longitudinal line that connects the cervix and the fundus of the uterus, or the length of the uterus;

the axis of the fetus is a longitudinal line that connects the head and buttocks of the baby.

The position of the fetus is the ratio of the axis of the baby to the axis of the uterus. There are two types of fetal position: correct and incorrect. The correct position is longitudinal, when the axis of the uterus and the axis of the fetus coincide, in other words, when the torso of the future mother and the torso of the child are in the same direction (for example, when a pregnant woman is standing, then the child is in vertical position). In this case, the pelvic end or head (large parts) of the child look in the direction of the entrance to the small pelvis, while the opposite part of the fetus rests on the bottom of the uterus.

The wrong position is considered to be an oblique, or transverse, position of the fetus. However, it must be remembered that for most of the gestation period, the fetus is mobile and changes its position. The stabilization of the child occurs by the 34th week, so talking about the incorrect position of the fetus before this period is not entirely appropriate.

Transverse position of the fetus

With a transverse arrangement, the fetus is located not along, but across the uterus, in other words, the axis of the fetus and the axis of the uterus are located perpendicular to each other, at an angle of 90 degrees. Since the child is in a transverse position, the presenting part is also absent, while large parts of the fetus are palpated on the sides of the uterus on the left and right, and are located above the iliac crests.

Oblique position of the fetus

The oblique position of the fetus is diagnosed when the axis of the child is at an angle of 45 degrees to the axis of the uterus. In this case, the buttocks or head are below the iliac crest. It is also possible to single out oblique position, code the axis of the fetus is located at an angle to the length of the uterus, but this angle does not reach 90 degrees, but exceeds 45 degrees.

It should also be said about the so-called precarious position fetus. In the case of intense mobility, the fetus may periodically change position, moving from oblique to transverse or vice versa.

Fetal presentation

The position of the fetus, in which its large part (either the buttocks or the head) is directed towards the entrance to the small pelvis, is called the presentation of the child. Accordingly, there are breech presentation (when the buttocks, legs are at the entrance to the pelvis) and head presentation (the head of the fetus is located at the entrance).

Factors contributing to the occurrence of malposition of the fetus

The reasons why the fetus is located across the uterus can be due to either reduced or increased motor activity of the baby, or uterine factors (the presence of obstacles in the uterus):

Myoma of the uterus.

The risk of improper location of the fetus in the uterine cavity increases if there are fibrous / myomatous nodes in it. The risk is especially high when myomatous nodes are localized in the cervix, lower uterine segment or isthmus, or if there are large nodes in size, which, although located in other places, prevent the fetus from taking the correct position. They also do not exclude the growth of neoplasms during pregnancy, which lead to deformation of the uterine cavity and forced malposition of the fetus.

Congenital malformations of the uterus.

Uterine anomalies such as a bicornuate or saddle uterus or the presence of a septum in the uterus also force the fetus to take a transverse position.

Misplacement of the placenta.

low placenta or low placenta(5 or more centimeters below the internal os), its presentation (partial or complete overlap of the placenta of the cervix of the uterus) is often the cause of the incorrect location of the fetus in the uterus.

Narrowed pelvis.

In most cases, narrowing of the pelvis of the first and second degree is not an obstacle to normal development, location and subsequent birth of the child. However, with more severe degrees of narrowing, and especially with asymmetric narrowing (curvature by bone exostoses, oblique pelvis), the likelihood of an oblique, transverse and mixed location of the fetus relative to the axis of the uterus increases.

Malformations of the fetus.

A certain part of the vices begins to manifest itself even when the child is in the womb. For example, with hydrocephalus (hydrocephalus, in which the head of the fetus is very large) or anencephaly (absence of the brain), an oblique / transverse arrangement fetus.

Pathology of amniotic fluid.

Excess amniotic fluid provokes excessive expansion of the uterine cavity, thereby increasing physical activity fetus. He ceases to feel the boundaries of the uterine cavity and begins to actively move, while occupying an oblique or transverse position. In the case of a lack of amniotic fluid, the situation is radically opposite. The tightness and lack of amniotic fluid do not allow the child to make active movements and take the necessary position.

Multiple pregnancy.

When several fetuses are present in the uterus at once, they experience tightness, as a result of which one or all babies occupy the wrong position.

Large fruit.

Significant weight and size of the fetus reduce it motor abilities, which leads to employment wrong position in the uterine cavity.

Increased tone of the uterus.

If there is a threat of termination of pregnancy, especially permanent, the uterus is in hypertonicity almost all the time, limiting the movement of the fetus.

Flabbiness of the muscles of the anterior wall of the abdomen.

This situation often occurs in women who have given birth a lot (4-5 births in history). The constant stretching of the anterior wall of the abdomen contributes to more active movements of the fetus inside the uterus (the abdominal muscles are not able to restrain the movements of the child), it begins to tumble and roll over, as a result, it is located incorrectly (obliquely or across) in the uterine cavity.

Fetal hypotrophy.

Insufficient size and weight of the child can also be the reason for his constant active movement and coups in the uterine cavity, since the child is small, and there is enough space in the uterus.

Diagnosis of the transverse position of the fetus in the uterine cavity

To determine the transverse position of the child, it is necessary to perform comprehensive examination pregnant woman:

Examination of the abdomen.

During examination of the abdomen of a pregnant woman, its irregular shape. The abdomen is stretched in a transverse size, in the case of a transverse position of the fetus in the uterine cavity, or obliquely stretched if the child is located obliquely to the axis of the uterus. In such cases, the uterus has the shape of a ball, while normally it should have an ovoid-elongated shape. In the course of measuring the size of the abdomen, it is found that its circumference significantly exceeds the norm, while the height of the uterine fundus does not coincide with the gestational age (less than the term).

Palpation of the abdomen.

During palpation of the anterior abdominal wall, it is not possible to determine a large part of the fetus when probing the area of the entrance to the bone ring of the small pelvis. In the area of the bottom of the uterus, the pelvic or head end is also not palpated. Large parts are palpable on the sides of middle line uterus. The position of the fetus is determined by the baby's head. If the head is located on the left, then they speak of the first position, if the head is located on the right - the second position. The fetal heartbeat is heard well in the navel, and not on the right or left, as in the correct position. There may be difficulties with establishing the position of the fetus in the presence of uterine hypertonicity and with an excess of amniotic fluid.

obstetric ultrasound.

obstetric ultrasonography allows you to determine the exact position of the fetus with a 100% guarantee, regardless of the gestational age. However, the transverse position of the fetus before the term of 20 weeks should not be a cause for panic, since the child may have time to take the necessary position before the due date.

Vaginal examination.

Vaginal examination, which is carried out at the end of pregnancy and during contractions, but still in general amniotic sac, gives some information regarding the position of the fetus. It is only possible to determine the fact that the presenting part of the fetus is missing at the entrance to the small pelvis. When opening the uterine os to 4 or more centimeters, as well as when water is poured out, a vaginal examination is performed with caution, since it can provoke prolapse of the umbilical cord loop, stem or handle of the fetus. With outflowing waters, the obstetrician can feel the ribs of the fetus, the armpit or shoulder blade, in some cases the hand or elbow is determined.

Features of the course of pregnancy and childbirth

Pregnancy in the presence of a transverse position of the fetus usually proceeds without any features. However, it is noted that in almost 30% of cases, preterm birth occurs. To the most frequent complications Such a pathology includes premature rupture of amniotic fluid, which can occur both during pregnancy and provoke the onset of preterm labor, and during the birth process.

Causes of complications of childbirth in the transverse position of the fetus

In exceptionally rare cases, it is possible to independently complete labor with the transverse position of the fetus, while the child is born alive. In such situations, the baby is independently rotated into a longitudinal position and its further birth is performed by the pelvic or head end. Self-rotation is possible in case of prematurity of the fetus or its small size. In most cases, the course of childbirth is unfavorable and can be complicated by such processes:

Untimely discharge of amniotic fluid.

With the transverse position of the fetus, early or premature discharge of water is observed in almost 99% of cases. This is due to the fact that the presenting part, which is pressed against the pelvic inlet, is absent and does not separate the water into posterior and anterior.

Launched transverse position.

Such a complication occurs after an early or premature discharge of water. In such cases, due to the rapid outflow of amniotic fluid, the child's motor activity is sharply limited, and small parts may fall out of the fetus or the shoulder will be driven into the pelvis. If the loop of the umbilical cord falls out, it is clamped, which leads to impaired blood flow and death of the fetus.

Rupture of the uterus.

The neglected transverse arrangement of the fetus is accompanied by the threat of uterine rupture. After the withdrawal of the amniotic fluid, the shoulder girdle of the fetus is pushed into the small pelvis, violent contractions of the uterus occur, which provoke overstretching of the lower segment of the organ and threaten to rupture it. If the caesarean section is not performed on time, the uterus will rupture.

Choriamnionitis.

Premature discharge of amniotic fluid and a long anhydrous period of time contribute to the penetration of infection into the uterine cavity and the formation of choriamnionitis, which leads to the development of peritonitis and sepsis.

Fetal hypoxia.

A long course of childbirth paired with a long anhydrous interval provokes the occurrence of fetal hypoxia and its birth in a state of asphyxia.

Childbirth with a double body.

Against the background of intense contractions and the outflow of amniotic fluid, a close contact of the fetus with the walls of the uterus appears, as a result of which the child bends in half in the thoracic region. In such cases, childbirth ends spontaneously. First comes to light rib cage with a pressed neck, then the stomach with a head pressed into it, and at the end of the buttocks with legs. The appearance of a live baby in such situations is unlikely.

Management of pregnancy and childbirth

The tactics of pregnancy management in diagnosing the transverse position of the fetus consists in carefully monitoring the condition of the pregnant woman, prescribing corrective gymnastics (only in the absence of contraindications) and limiting physical activity. Up to 32-34 weeks, the oblique or transverse position of the fetus is considered unstable, at this time there is a high probability of the child twisting into a longitudinal position.

Previously, in obstetric practice, the external rotation of the fetus was widely practiced, the purpose of which was to give the fetus a longitudinal position. Obstetric external rotation was performed at 35-36 weeks at normal condition pregnant and total absence contraindications. Today, this technique for correcting complications is ineffective and is used in exceptional cases, due to the many contraindications and complications after its implementation. During the rotation, there is a possibility of placental abruption and subsequent fetal hypoxia, there is also high risk uterine rupture.

Corrective gymnastics

Special exercises can be prescribed in the absence of contraindications and evidence of the presence of an incorrect position of the fetus. Contraindications for gymnastics:

bleeding from the birth canal;

little or polyhydramnios;

uterine fibroids;

uterine hypertonicity;

severe somatic pathology in a pregnant woman;

scar on the uterus;

multiple pregnancy;

pathology of the umbilical vessels;

abnormal location of the placenta (previa or low placenta).

Gymnastics according to Dikan has proven itself excellently. A woman should perform a series of simple exercises three times a day: roll over from one side to her side and lie on her side after turning for 15 minutes (for each side). This exercise is performed three times.

A set of exercises that provokes rhythmic contractions of the muscles of the trunk and abdomen and is performed in combination with deep breathing.

Pelvic tilt.

The woman lays down on hard surface, the pelvis is raised. The position of the pelvis should be 20-30 cm higher than the head. You should be in this position for 10 minutes.

Exercise cat.

In the kneeling position, the hands rest on the floor. During inhalation, the coccyx and head rise, and the lower back bends. When exhaling, the back arches and the head drops. 10 repetitions are needed.

Knee-elbow posture.

Knees and elbows rest on the floor, at the same time, the pelvis should be above the head. In this position, you must be for 20 minutes.

Half bridge.

Lie on a hard surface, and lay the buttocks on the pillows. Raise the pelvis by 40 cm, raise the legs.

Lifting the pelvis.

Lying on the floor, bend your legs at the hip and knee joints, rest your feet on the floor. On each breath, lift the pelvis and hold it in this position. On each exhalation, the pelvis lowers, the legs straighten. The exercise is repeated up to 7 times.

In most cases, corrective gymnastics must be performed within 7-10 days, during which time the fetus occupies the correct position (longitudinal). Exercise should be done three times a day.

After the fetus returns to the correct position, the woman is prescribed a bandage with longitudinal rollers. Wearing a bandage allows you to fix the result. The wearing time usually lasts until the baby's head is pressed against the entrance to the small pelvis or until the beginning labor activity.

Birth management

The optimal methods of delivery in the presence of a transverse position of the fetus is considered a planned caesarean section. A pregnant woman is hospitalized at week 36, undergoes a thorough examination and is prepared for surgery. Having a baby naturally is unlikely because spontaneous reversal is very rare. Carrying out childbirth in a natural way with the subsequent rotation of the fetus on the leg (external-internal) can be only in 2 cases:

twin childbirth, provided that the second baby is located across;

the fetus is severely premature.

A planned caesarean section before the onset of labor is performed in such cases:

fetal hypoxia;

uterus with postoperative scars;

uterine tumors;

placenta previa;

prenatal outpouring of water;

true reversal.

In rare cases, at the beginning of contractions, the fetus can move from a transverse to a longitudinal position, and, accordingly, childbirth will take place naturally. In the case of an oblique position of the fetus, the woman in labor is placed on that side, the bottom of which corresponds to the large part of the child. A woman is forbidden to stand up, she must be in a horizontal position.

If a child's legs or arms fall out, under no circumstances should they be set back. Firstly, this will not bring results, and secondly, there is a high risk of injury to the child, in addition to additional infection of the uterus and delaying the time before surgical delivery.

In the case of a neglected transverse position of the fetus, an immediate caesarean section is required, regardless of the condition of the child (he is dead or alive). Some obstetricians in the case of a neglected transverse position and death of the fetus use a fruit-destroying operation. However, such surgical interventions very dangerous because they can lead to uterine rupture. If there are signs of infection (purulent discharge from the uterus, heat), caesarean section ends with hysterectomy and drainage of the abdominal cavity.

The combined external-internal rotation is performed under strict observance of the following conditions:

small size of the fetus (no more than 3600 g);

there are no strictures and tumors of the vagina, tumors of the uterus;

expanded operating room;

preserved fetal mobility;

the size of the baby's head corresponds to the size of the pelvis of the woman in labor;

consent of the woman;

a catheter that drains the bladder;

full opening of the uterine os;

live fruit.

Difficulties that are possible when performing a combined turn:

development of infectious complications in the early postpartum period;

birth injury;

fetal hypoxia, which leads to intrapartum death;

prolapse of the umbilical cord loop, after performing the turn - a quick mandatory extraction of the child by the leg;

falling out of the handle or removing it instead of the leg - putting a loop on the handle and leading it to the head of the fetus;

uterine rupture is an emergency operation;

rigidity (lack of elasticity) of the soft tissues of the birth canal - the introduction of antispasmodics, the selection of an appropriate dose of narcotic drugs, the performance of an episiotomy.

The most frequent questions on the topic

During the second ultrasound, I was diagnosed with a pregnancy of 23-24 weeks with a transverse position of the fetus. What can I do to get my child in the right position?

This short term pregnancy, so no action is required. The child occupies the final position by 34-35 weeks, and until this time he freely moves through the uterine cavity.

On last ultrasound the transverse position of the fetus was established, the period of 32 weeks. Is gymnastics required in order for the child to “lay down” longitudinally?

The expediency of performing corrective gymnastics should be discussed directly with the obstetrician leading the pregnancy. Only with the permission of the obstetrician, you can resort to performing exercises to turn the child into the correct position, since there are a number of contraindications for gymnastics.

I am pregnant with twins, 36 weeks. The first child is in a breech presentation (legs), while the second lies across. Is it necessary to perform a caesarean section?

Yes, in such situations, the implementation of a planned delivery is the most optimal and safe method both for the mother herself and for her children. If the first child were in a purely gluteal position, then childbirth can be carried out naturally, followed by a combined rotation of the second child on the leg. However, in this situation, even at the birth of the first child naturally difficulties will arise, since the birth of the legs can occur before the cervix is fully dilated, and this will make it difficult not only to give birth to the head, as the largest part of the child, but also to the pelvis.

The presentation of the fetus determines the method and method of delivery. To make an accurate diagnosis, it is necessary to conduct an ultrasound. An experienced doctor can determine the presentation of the fetus as early as the twenty-second week. But before the onset of labor, this situation may change. The final intrauterine position of the fetus is established at the thirty-sixth week.

The most correct and optimal is considered longitudinal. It is the most common, and with it the baby's head lies down in the direction of exit from the uterus. In such a presentation with a qualified medical care childbirth will be successful and with the least pain.

Childbirth with longitudinal head presentation in most cases takes place naturally. Except in cases where the fetus is too large (more than 3600 g) or the size of the pelvis of the expectant mother does not allow the baby's head to pass. Such situations may be an indication for a caesarean section.

Defining what it means cephalic presentation fetus, it is important not to confuse this concept with the position of the fetus. The longitudinal position of the fetus in head presentation can have two positions:

1 position head presentation - the back of the baby lies to the left uterine wall;
2 position head presentation - the back of the fetus is facing the right uterine wall.

There are also types of positions: front, in which the back is turned forward, and rear view of the head presentation - in which the back is turned backward.

Low cephalic presentation of the fetus

Define low position fetus can be from the twentieth to the thirty-sixth week. Then, as the lowering of the fetus at normal course pregnancy occurs at the thirty-eighth week. This diagnosis should not lead to panic. This situation can provoke premature birth, but if you follow all the doctor's recommendations, then the birth will take place safely and on time.

If a pregnant woman is diagnosed with a low head presentation of the fetus, it is recommended to wear a special prenatal, limit physical exercise, do not run and rest more often.

In the normal course of childbirth with a longitudinal head presentation of the fetus, the birth canal is the first to pass through the head, and then the entire body slips out. Women who are at risk of giving birth with pathologies are recommended hospitalization, where they will be under the supervision of specialists.

Each future mother I want the pregnancy to go well, and the baby to develop in the womb in accordance with accepted standards.

But not all women understand the terminology that doctors use in documents. Therefore, pregnant women often have questions about medical reports. Often they are also placed about the location of the fetus in the uterus.

What does the longitudinal position of the fetus mean

When future mom receives the results in his hands, he sees a diagnosis that concerns the location of the child in the womb. Not everyone understands the meaning of medical terms, conclusions, and even if the doctor says that everything is fine with the child, they are tormented by doubts. So, how does the position of the baby in the mother's stomach affect pregnancy and future births?

This question is of most concern to primiparous women. What does the position of the fetus longitudinal mean? How to understand this medical term? The longitudinal position of the fetus is the most optimal and correct for a healthy delivery. This means that the axis, that is, a straight line running along the fetal spine, is strictly along the axis of the uterus.

If the medical report says that the position of the child is longitudinal, then everything is fine with you! Your baby lies with the head towards the exit of the uterus, and the birth will be successful, less painful. You should know that the longitudinal position of the child in the uterus is the most common. This placement of the fetus occurs in 95-97% of cases. But the remaining 3-5% is the breech presentation of the fetus. Childbirth with such a presentation is considered pathological.

If the position of the fetus is longitudinal, the baby is not large, the size of the mother's pelvis allows the passage of the baby's head, then he will be born naturally. The child will descend through the birth canal and gradually expand them. After the birth of the head, the rest of the body will slip out of the mother's womb.

And if the presentation is breech?

Such a presentation always complicates natural childbirth, although it is rare. Those 3-5% of women in labor who have such a presentation fall into the risk zone. Only in extreme cases in this position of the child, childbirth is possible in a natural way. In most cases, a caesarean section is still prescribed. In isolated cases, women give birth themselves, but these are rather difficult births. First, they must be fast in order to avoid complications. A woman will need it very much, and in such situations, literally every second is precious. born with breech presentation babies under one year old should be regularly observed by an orthopedist in order to control the condition and development of the hip spine.

Secondly, breech presentation during childbirth can lead to bleeding. A uterine bleeding both for the child and for the mother are very dangerous.

Changing positions of the fetus before birth

It is impossible to determine exactly the reasons why the child takes a certain position in the uterus. Until the end of the second trimester of bearing a baby, he is constantly in motion, changing position ten times a day. This suggests that he is very comfortable in his mother's womb. As the baby grows in the mother’s stomach, it already becomes crowded, and therefore, closer to childbirth, he occupies a certain position.

Why is the head in the longitudinal position exactly at the bottom of the uterus? Doctors say that the head is displaced by the weight of the fetus. But this is only an assumption, and usually the position of the fetus directly depends on the uterus, its contractions and the size of the pelvis of the pregnant woman.

How to correct the position of the child in the womb?

If the child did not settle properly before the birth, and there is still time until the delivery itself, then everything can be corrected. To do this, the mother must constantly change her posture and be in a position that can facilitate the movements of the child. If, for example, the head is displaced to the side and is not on a straight axis, then the woman should more often lie on her side, where the fetus is located. And as soon as the baby takes the right position, doctors recommend fixing this position by wearing a bandage.

Psychologists advise mothers not to be nervous about wrong posture child. They recommend talking to the baby more often, stroking your stomach, and asking for the baby. It is necessary to explain to him affectionately and often that it will be better for him this way. The mother's voice has a great effect on the child. He may well roll over before childbirth and take the correct position.

Especially for Elena TOLOCHIK

head longitudinal presentation fetus - photo and characteristics this provision when the head of the unborn child is turned towards the entrance to the small pelvis. You can find out the presentation of the fetus during the examination, using special obstetric techniques, as well as ultrasound. The most common and preferred is cephalic presentation, which guarantees easy independent childbirth.

What is cephalic presentation of the fetus? Photo and description of the situation.

Head presentation is the most favorable position of the fetus in the uterus. This is known to all expectant mothers. However, few people know that even if the child lies head down, sometimes he will not be able to go out on his own. The success of childbirth depends on the size of the fetus, on the activity of labor and on some nuances of the position of the unborn baby in the uterus.

Longitudinal head presentation includes several variations in the location of the fetal head: anterior head, occipital, facial and frontal. The most optimal in obstetrics and gynecology is considered to be the occipital flexion presentation. In this case, the small fontanel acts as the leading point for moving along the birth canal. With a similar version of the presentation, the neck of the child, in the process of passing through the birth canal, bends so that at the time of birth, the back of the head facing forward initially appears. Up to 95 percent of all births proceed in this way.

But with cephalic presentation, there are also variations in the extensor insertion of the head, which differ from each other.

Interesting on the net:

A similar presentation of the head as a wire point during the period of exile uses a large fontanelle. The possibility of independent childbirth is also not excluded, but the probability of birth traumatism of the newborn and mother is much higher than with occipital presentation. Childbirth has a protracted course, and therefore in such a case fetal hypoxia should be prevented.

Second degree: fetal position - longitudinal presentation head, frontal.

In this case, the fetal head also enters the small pelvis maximum size. The forehead acts as a wire point, which is lowered below the rest of the head. In this variant, independent childbirth is impossible, operative delivery is desirable.

Third degree - facial presentation.

The extreme degree of extension of the head is the facial presentation. In this version, the chin is used as the leading point, the baby's head comes out of the birth canal with the back of the head. In such a case, the possibility of natural childbirth is not ruled out if the woman has a large pelvis or a small fetus. However, face presentation is usually an indication for a caesarean section.

The reasons for various non-standard fetal presentations are the small width of the pelvis in a pregnant woman, the abnormal structure of the uterus, uterine fibroids, limiting the space available for the child, placenta previa, polyhydramnios, flabby abdominal wall, heredity, and so on.

How to diagnose cephalic presentation of the fetus?

The presentation of the fetus is determined by the obstetrician-gynecologist. This can be done from the 28th week of gestation with the help of an external obstetric research. To this end, the doctor places his open palm over the symphysis, covering the presenting part of the child. In the case of head presentation above the entrance to the small pelvis, you can determine the head, which is palpable with a rounded dense part. The data obtained during an external examination should be clarified by a vaginal gynecological examination.