So the position of the fetus is longitudinal presentation of the head. The position of the fetus is longitudinal with head presentation

Head presentation of the fetus is the natural, correct and normal position of the fetus in the uterus during pregnancy and childbirth, passing without pathologies. A cephalic presentation baby is placed head down in the uterus. But, behind this definition lies such options for situations that can affect the tactics of childbirth, the prevention of complications during childbirth and after them. Examples of such situations are parietal, frontal or facial presentation. With these types of location of the child, it is necessary medical assistance which often ends in a caesarean section.

Types of head presentation of the fetus

Fetal position longitudinal presentation the head has varieties. According to which part of the baby's head passes through the birth canal, the following types are distinguished:

occipital cephalic presentation the most optimal, both for a woman and for a child in natural childbirth. The child passes through the birth canal with a fontanel. In this case, the neck is bent in such a way that the occipital region of the head is shown first. Moving forward along the birth canal, the head turns, as a result of which the back of the head turns to the pubic bones, and the baby's face to the sacrum. This is the most non-traumatic passage of the child, both for him and for the woman. When erupted, the head unbends. The baby's shoulders unfold, the head also unfolds so that the baby's face turns to the hip of the woman in labor. Behind the exit of the shoulders, the torso and legs of the newborn already easily appear. Almost 90% of all births go by this option.
Parietal presentation is characterized mild degree extension of the head. It can be anterior and posterior, temporary or remain until delivery. The causes of this pathology are: a flat pelvis, a small fetus with an extensive pelvis, anomalies in the development of the pelvis, anomalies in the development of the occiput and atlantooccipital joint in the fetus, polyhydramnios, etc. Birthing can go like naturally, and operational. There is a warning in childbirth;
Frontal presentation head longitudinal. Baby is coming along the birth canal forehead forward. At the same time, his movement is delayed, as this is hindered by the chin, which does not have the ability to lower. This condition leads to complications for both the woman (rupture of the uterus) and the child (asphyxia and death). The frequency of frontal presentations is low. Delivery is almost always operative;
Facial head longitudinal presentation of the fetus. He is characterized high degree extension of the baby's head moving along the birth canal. The child comes out with the back of the head, which causes serious complications for both the woman (extensive ruptures of the perineum and pelvic muscles) and the child. He is born with large swelling of the face, neck and tongue. With this variant of presentation (meets 1: 1000), both the natural course of childbirth and surgical intervention.

In cases where the position of the fetus is longitudinal, the presentation is head, it is important to know not only its types, but also the positions. The head presentation is the first position: the child lies with his back against the left wall of the uterus. This variant is more common than cephalic presentation, position two, when the baby is back against the right wall of the uterus. Obstetricians also take into account the types of positions: front - when the back of the child is turned anteriorly, and rear, when the back is turned backwards.

The position of the fetus longitudinal presentation head, low

The outcome of childbirth with a head longitudinal presentation of the fetus is due to another important factor - low head presentation. What does cephalic presentation of the fetus mean? This is a type of cephalic presentation of the fetus when it descends earlier than expected. With a normal pregnancy, the fetus descends shortly before childbirth, at 38 weeks.

With a low presentation, it drops very early (from 20 to 36 weeks). The low position of the longitudinal presentation of the head can be determined by the obstetrician by palpating the uterus. The head of the child is at the same time quite low above the entrance to the small pelvis. She is inactive or, or motionless at all. Circumstances that have arisen can lead to premature birth.

If appropriate measures are taken, then childbirth takes place without complications, and a baby is born healthy child. It must also be taken into account that the child can change its location up to 32 weeks. Since there is still enough space inside the uterus for this. To prevent labor from starting prematurely with a low head longitudinal presentation of the fetus, a woman should use a prenatal bandage, avoid physical exertion, spend more time on fresh air, choose quiet types of recreation.

Factors of negative situations in head presentation

Among various factors causing undesirable situations can be: the narrowness of the pelvis of the woman in labor, an anomaly in the development of the uterus, polyhydramnios pregnancy, hereditary diseases, neoplasms of the uterus,.

Diagnosis of the position of the longitudinal presentation of the head

The classic method for determining cephalic presentation is obstetric examination at 28 weeks gestation. With a natural delivery position, longitudinal, head presentation, the movable head is well defined above the pubic joint. More modern and precise definition the position of the fetus is performed on ultrasound (at 22 weeks).

This study clarifies the location of all members of the body, presentation, the position of the fetus and its appearance. Modern is more effective and informative than obstetric examination, which gives a certain percentage of erroneous diagnoses.

The position of the fetus is the ratio of its axis (which passes through the head and buttocks) to the longitudinal axis of the uterus. The position of the fetus can be longitudinal (when the axes of the fetus and uterus coincide), transverse (when the axis of the fetus is perpendicular to the axis of the uterus), and oblique (middle between the longitudinal and transverse).

The presentation of the fetus is determined depending on the part of it that is in the area internal os cervix, that is, at the place where the uterus passes into the cervix (the presenting part). The presenting part can be the head or the pelvic end of the fetus; in the transverse position, the presenting part is not determined.

head presentation

Head presentation is determined in approximately 95-97% of cases. The most optimal is occiput presentation when the fetal head is bent (the chin is pressed to the chest), and at the birth of the baby, the back of the head comes forward. The leading point (the one that first goes through the birth canal) is a small fontanelle located at the junction of the parietal and occipital bones. If the nape of the fetus is turned anteriorly, and the face is backwards, this is the anterior view of the occipital predilection (more than 90% of births occur in this position), if vice versa, then the posterior. In the occiput posterior presentation, childbirth is more difficult, during childbirth the baby can turn around, but childbirth is usually longer.

With cephalic presentation, the pelvic end of the fetus may deviate to the right or left, depending on which way the back of the fetus is facing.

Also, extensor types of head presentation are distinguished, when the head is unbent to one degree or another. With a slight extension, when the leading point is a large fontanelle (it is located at the junction of the frontal and parietal bones), they speak of an anterior presentation. Childbirth through the natural birth canal is possible, but they take longer and are more difficult than with occipital presentation, since the head is inserted into the small pelvis in a large size.

Therefore, cephalic presentation is a relative indication for surgery. caesarean section. The next degree of extension is frontal presentation(it is rare, in 0.04-0.05% of cases). At normal sizes fetus delivery through the birth canal is impossible, it is required operative delivery. And finally, the maximum extension of the head is the facial presentation, when the fetal face is born first (it occurs in 0.25% of births). Childbirth through the natural birth canal is possible (in this case, the birth tumor is located in the lower half of the face, in the area of the lips and chin), but they are quite traumatic for the mother and fetus, so the issue is often resolved in favor of a caesarean section.

Diagnosis of extensor presentation is carried out during vaginal examination during childbirth.

Breech presentation of the fetus

Breech presentation occurs in 3-5% of cases and is divided into foot presentation, when the legs of the fetus are presented, and gluteal, when the baby is squatting, as it were, and his buttocks are presented. more favorable.

Childbirth in breech presentation considered pathological due to a large number complications in the mother and fetus, since the first to be born is a less voluminous pelvic end and difficulties arise when removing the head. At foot presentation the doctor delays the birth of the child with his hand until he squats down to prevent the legs from falling out, after such a benefit, the buttocks are born first.

Breech presentation is not an absolute indication for caesarean section. The question of the method of delivery is decided depending on the following factors:

the size of the fetus (with a breech presentation, a large fetus is considered to be more than 3500 grams, while during normal childbirth - more than 4000 grams);
the size of the mother's pelvis;
type of breech presentation (foot or gluteal);
gender of the fetus (for a girl, childbirth in a breech presentation is associated with a lower risk than for a boy, since the boy may have damage to the genitals);
woman's age;
flow and outcome previous pregnancies and childbirth.

Transverse and oblique position of the fetus

The transverse and oblique positions of the fetus are an absolute indication for caesarean section, childbirth through the natural birth canal is impossible. The presenting part is not defined. Such positions are determined in 0.2-0.4% of cases. The previously used turns by the leg during childbirth are now not used due to the great trauma for the mother and baby. Occasionally, a similar rotation can be used for twins, when, after the birth of the first fetus, the second took a transverse position.

The transverse position may be due to tumors in the uterus (for example,), which prevent them from taking a normal position, in multiparous women due to overstretching of the uterus, with large fruit, with a short umbilical cord or its entanglement around the neck.

In the absence of reasons preventing the fetus from turning on the head, you can perform the same exercises as with breech presentation. In an oblique position, you need to lie more on the side where the back is predominantly facing.

The position of the fetus in twins

With twins, vaginal delivery is possible if both fetuses are in the head presentation, or if the first (which is closer to the exit from the uterus and will be born first) is in the head presentation, and the second in the pelvic. If, on the contrary, the first is in the breech presentation, and the second in the head, the situation is unfavorable, since after the birth of the pelvic end of the first fetus, the babies can catch on their heads.

When determining transverse position one of the fetuses, the issue is resolved in favor of a caesarean section.

Even with a favorable arrangement of the fetuses, the question of the method of delivery for twins is decided not only on the basis of the position, but also depending on many other factors.

Comment on the article "Position and presentation of the fetus"

bandage - the position of the fetus. Personal impressions. Pregnancy and childbirth. bandage - the position of the fetus. the doctor with my back advised me to buy and wear a bandage. but I have a baby know what's on later dates do not recommend a breech bandage to give the child ...

Discussion

The doctor told me that the bandage does not fix the position of the child. He is in the water, and there is a lot more around the child.
To really "squeeze" the child somehow, you need to pull off the bandage from some incredible strength, this is simply unrealistic.

I didn’t understand at all whether everyone needs a bandage and when should I start wearing it? And does it depend on the abdominal muscles that someone holds the tummy himself, and someone needs support in the form of a bandage?

Pregnancy, childbirth and breech presentation of the fetus. How to fix? Are possible natural childbirth with a breech presentation of a child. Ever since we were told we were upside down at 30 weeks, I've done a bunch of different exercises and fretted about...

Discussion

I have a boy, also pelvic, but they said that he would roll over, I also really don’t want a CS, but if the baby doesn’t turn, I won’t injure, it’s better than the CS than the baby’s suffering. and find out the gender of course.

I have a girl friend 14 years ago gave birth to a daughter in the pelvis. Doctors refused to do CS: "second birth, you will give birth yourself." Result: at cerebral palsy child in severe form.

Incorrect presentation of the fetus. The ideal position of the baby in the uterus is longitudinal with the occipital presentation, that is, head down, with the chin tightly pressed to the chest. But it is important to understand that the incorrect position of the child is a feature of the flow ...

According to ultrasound, cephalic presentation, so I’m still wondering why she hammers so hard there) of the abdomen so that by slightly pushing the stomach from one hand to the other and back, it is possible to determine whether the position of the fetus can be determined longitudinally. Where it is most active...

Discussion

Don't understand. maybe the legs, and the arms, and the butt, and the knees and elbows move :))

it will grow up a little more, and it will be possible to touch :) you find such a concrete hillock - this is the priest. from it in one direction the back goes in such an arc (very easy to determine), and in the other direction the legs hang down (if you press, you can find small such bumps or just uncertainties such when everything is wrapped inside). and the hairs are both from the hands and from the legs. and even from the priests with his head, on your term: o) and he still has time to settle down with his head down, don't worry!

Our baby has up to last ultrasound came to light breech presentation. But at 36 weeks, the doctor determined (by touch) that the baby had turned over, although it is believed that this is possible mainly until 32 weeks. By the way, the wife practically did not do exercises for ...

Many pregnant women are frightened when gynecologists pronounce incomprehensible and complex words during the examination. medical terms. In the process of ultrasound monitoring, young mothers sometimes hear about the head presentation of the fetus. What does it mean? Is this the norm or pathological condition causing serious damage to the baby in the womb? There is no need to panic: the attending physician tells in detail about the head presentation.

What is cephalic presentation of the fetus?

Pregnant women often hear this wording from gynecologists during examinations from the 30th week of gestation. Far from all expectant mothers understand a complex medical phrase, so they begin to worry about the condition of the baby developing in the stomach. What is fetal presentation, is the head position a norm or a dangerous pathology?

When a doctor talks about presentation, he means the position of the child's torso from the back of the head to the sacrum relative to the uterus. That is, the head presentation of the fetus is the longitudinal position of the fetus with the placement of the head in the pelvic area. This location of the baby is correct, observed in 97% of mothers preparing for childbirth. In about 3% of women, the crumbs sit down with their ass on their mother's small pelvis, or they can generally lie down horizontally. In such a situation, childbirth is complex and pathological.

What is head presentation of the fetus?

Gynecologists distinguish four types of head location of the child:

Occipital. Obstetricians consider this position the most convenient and safe. When the baby moves through the birth canal during childbirth, his neck is in a bent state. The nape of the baby emerges first from the mother's vagina. More than 95% of births proceed as described above. With occiput presentation, most babies are born without injury, and mothers are usually not diagnosed with ruptures.
Facial. In this position, the baby's head is strongly thrown back. In the process of childbirth, the baby's face is shown first from the mother's genital tract. Usually, with facial placement of the fetus, doctors send patients to a caesarean section to prevent complications. Although many women give birth successfully and natural way.
Execution. This type of presentation is recorded extremely rarely. During childbirth, the baby's forehead comes out first from the mother's vagina. In this position of the fetus, it is mandatory to appoint surgical intervention, natural childbirth is not allowed.
Anterior head. This type of presentation is also called anterior parietal. The first fontanel of the child, located on the top of the head, is shown from the vagina. With an anterior head placement of the fetus, you can give birth both by caesarean section and in a natural way. But with natural childbirth, the baby is more likely to be injured. There is also a high risk of hypoxia of the baby in the process of coming out into the world.

The location of the baby in the womb is also determined by two positions. When the baby is in the first position, then his back is adjacent to the left side of the uterus. Most babies develop in this position. If the child leans back against the right side of the uterus, then he is in the second position. Sometimes babies press their backs against the anterior or posterior mucous surfaces of the uterus.

What to do with a low head presentation of the fetus?

Doctors usually tell women about low cephalic presentation of the fetus at 20 weeks of gestation. It too early term, normally, the child, preparing for birth, should descend into the pelvic cup at 38 weeks. Due to the low head presentation of the fetus at 20 weeks, the risk of preterm labor is high. But there is no need to worry: gynecologists are closely monitoring the condition of patients with an unfavorable diagnosis. Young mothers who have a low head presentation of the fetus in the womb should heed all the advice medical professionals, move with extreme caution. Doctors recommend that women with a low placement of the child:

wear special support bandages;
exclude intense physical activity;
often rest lying down;
do not run, do not make sudden and rapid movements.

In the vast majority of cases, childbirth with a low position of the baby takes place in normal term are not accompanied by complications.

What causes fetal misalignment?

Sometimes gynecologists diagnose in pregnant women not the head presentation of the fetus, but the pelvic one. That is, the baby is not placed in the uterus upside down, but sits in the bowl of the mother's small pelvis with legs or ass. Provoke not correct position child the following factors:

narrow hips at mother;
myoma;
polyhydramnios, which increases the activity of the fetus;
oligohydramnios, interfering with the mobility of the baby;
placenta previa;
abnormal structure of the uterine walls;
low contractility of the muscles of the uterus;
genetic predisposition;
constant squeezing of the abdomen during daytime rest and night sleep;
wearing uncomfortable and tight clothing.

With pelvic or transverse arrangement the child's gynecologist decides which method to carry out obstetrics. With pelvic placement of the fetus, both ordinary childbirth and surgical intervention are allowed. Obstetricians perform a caesarean section in cases where the woman in labor has too narrow hips, or if the baby is large. At transverse presentation when the baby is located horizontally in the uterus, obstetric care is carried out exclusively by caesarean section. Natural childbirth is contraindicated.

How is head presentation diagnosed?

How is head presentation of the fetus detected during pregnancy? At about 30 weeks of gestation, the expectant mother learns from the gynecologist detailed information about the location of the baby in the uterine cavity. Diagnosis of presentation is usually carried out by means of a standard gynecological examination. The gynecologist plunges his fingers into the patient's vagina, gropes the crown of the fetal head above the pelvic cup. At pelvic location the doctor's fingers stumble on the legs or ass of the crumbs. To confirm the diagnosis, the patient is sent for ultrasound monitoring.

A medical specialist is able to determine the head presentation of the fetus as early as 20 weeks. But it is still not advisable to carry out diagnostics before the 30th week, since before this period the baby does not yet occupy the entire space of the uterus, therefore it is able to roll over several times. Mom herself at home can find out the location of the child in the womb. To do this, she should lie down on her back, spread her legs not wide, bend her knees, put her hand on the lower abdomen. Slightly pressing her hand on her stomach, the woman gropes for a hard and rounded object with a longitudinal head presentation of the fetus. This is the baby's head. To calm down too excited and confused young mothers who have little understanding of anatomy, some gynecologists show them the head presentation of the fetus in a photo or schematic illustrations. After all, women who are versed in physiological features childbirth, worry a little.

How is childbirth carried out with different types of head presentation of the fetus?

Obstetricians call childbirth safe, in which there is a longitudinal occipital position of the fetus, head presentation of the fetus. When the baby goes out through the vagina, he tilts his head, his chin is pressed against his neck. The head, pushing forward, makes a turn. The child's face turns to the maternal sacrum, and the back of the head - to the pubic symphysis. When the head finally emerges from the vagina, it unbends, then the baby's shoulders straighten, and the face turns to the mother's thigh. The shoulders and head come out the hardest of all, the trunk and limbs leave the birth canal without difficulty.

With the occipital location, childbirth often proceeds with complications. The baby's head turns in the birth canal incorrectly: the face looks at pubic symphysis, and the back of the head - on the maternal sacrum. As a result, the exit of the head to the outside is delayed. There is also a risk of weakening labor activity, which is very dangerous for a newborn baby. In this situation, obstetricians are forced to subject the woman to stimulation. The use of obstetric forceps is indicated when asphyxia occurs in an infant due to a long stay in the genital tract.

With a facial arrangement, natural childbirth is allowed only if the woman has enough wide hips, the fruit is not large, generic activity proceeds intensively. During childbirth, obstetricians closely monitor physical state and the well-being of the woman in labor, by means of cardiotocography, the heart rate of the child being born is calculated.

With the frontal position of the fetus, natural childbirth is allowed in extremely rare cases, since they are almost always accompanied by severe complications: ruptures of the vagina and cervix, the formation of vaginal fistulas, and even the death of an unborn baby. To correct the location of the head, the obstetrician can gently turn the baby around. If the reversal is not possible, then the doctor decides to perform the operation.

In the anterior head position, childbirth is often carried out in a natural way. But if the obstetrician understands that the health of the mother and the life of the child are in danger, then he appoints a caesarean section.

The location of the fetus in the uterus largely determines how the birth will take place. On an ultrasound scan in the third trimester, the doctor examines the position of the baby, making one or another conclusion. But medical terms, such as the longitudinal position of the fetus or the transverse position, may be incomprehensible to many expectant mothers, especially those who are in interesting position for the first time, which in turn causes certain anxieties and feelings.

Types of fetal position

Longitudinal position

In this position, the longitudinal axes of the baby (the line of the back of the head, spine, tailbone) and the uterus coincide. The longitudinal position of the fetus is the norm, which means that childbirth is possible naturally. The best option is the occiput presentation, when the baby's head is slightly lowered forward, and the chin is pressed to the chest. With the longitudinal position of the fetus, the largest part is born first - the head, which means that the rest of the body will literally slip through the birth canal without complications.

Another type of longitudinal position of the fetus is. With this arrangement of the fetus, childbirth is significantly complicated, since the child in the uterus is legs forward, which can cause some difficulties in the birth of the head. In turn, breech presentation with a longitudinal position of the fetus can be gluteal and foot. The first option is the most favorable, since the probability of a leg falling out is practically excluded, which means that the risk of injury is much lower. It is worth noting that with breech presentation, childbirth can also take place naturally. The question of the appointment of a caesarean is decided taking into account the size of the fetus and the pelvis of the mother, the type of presentation, the sex of the child, the age of the woman and the characteristics of the course of pregnancy.

Oblique and transverse position

In an oblique position, the longitudinal axes of the fetus and uterus intersect under acute angle, with a transverse - under a straight line. Similar arrangements of the baby in the uterus are almost always an absolute indicator for a caesarean section. Earlier in medical practice, such a technique as “turning by the leg” was used, which was performed by the doctor already in the process of childbirth. Today, due to the high traumatism of the mother and baby, this practice has been abandoned.

Change in the position of the fetus

So, in the period from 32 to 36 weeks, the child should take the head longitudinal position. It is worth noting that the wrong position of the baby is quite a rarity. So, for example, transverse oblique position occurs in only 2-3% of women. Change the wrong position to a longitudinal head fetus can independently at any time, so understand exactly how the baby is located in this moment, only constant supervision at the doctor will help or assist. Despite the fact that at a later date due to large sizes it is already difficult for the baby to roll over, the position of the fetus can change immediately before the birth itself, so you should not panic.

There are also a number of exercises that will help the child get into the right position. So, for example, it is recommended to lie on each side for 10 minutes, changing position 3-4 times. Repeat the exercise several times a day before meals. The knee-elbow pose and exercises in the pool also contribute to the result.

After the baby has turned head down, many doctors recommend wearing a special one that will fix the correct position. Most often, pregnant women wrong presentation 2 weeks before delivery, the fetus is placed in a hospital, where, under the supervision of specialists, a delivery plan is drawn up.

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. Unless the fetus is too large (more than 3600 g) or the size of the pelvis future mother does not allow the child's head to pass. Such situations may be an indication for a caesarean section.

When determining what cephalic presentation of the fetus means, 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 may lead to premature birth, but if you follow all the recommendations of the doctor, 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.