Transverse presentation of the fetus 25 weeks. Transverse presentation of the fetus: why it occurs and how to determine

22.07.2019

Pregnancy is one of the happiest stages in a woman's life. But in the same period, problems occur that darken the happiness of future motherhood. One of these problems is the transverse presentation of the fetus. It leads to problems during childbirth and poses a threat to the life and health of the baby and mother.

Why is the child in this position?

The final position of the child is determined at 32 weeks of gestation, since at earlier stages he can change it on his own several times. Most often, the child takes a normal position - with the head towards the birth canal.

But it so happens that it can be transverse or oblique. Transverse is characterized by the fact that the transverse axis of the baby's body is at right angles to the axis of the uterus. Oblique presentation - at an acute angle. Both cases are pathological.

This is usually explained by:

... This state creates conditions for the fetus to move actively.
Flabby muscles. Most often, flabbiness is characteristic of the second and subsequent pregnancies, when the mother's muscles are no longer able to fix the fetus in one position, and it continues to move even for long periods.
... The baby is looking for the most comfortable position during pregnancy. The nodes in the uterus, which are formed by the tumor, interfere with it. In this case, the fetus will take such a position that the head does not touch them.
Deviations in the structure of the uterus. Often there are pathologies such as a saddle and two-horned uterus. If the shape of the uterus is non-standard, then the baby may also be uncomfortable in the right position to be in the womb. He will move to take the most comfortable position.
Abnormalities in the development of the fetus.
Premature birth. The child does not have time to roll over after the water has departed.
The structure of the female body. If the woman has too much, the head of the fetus cannot take the necessary position.
Multiple pregnancies. Two or three fetuses prevent each other from taking the correct position in the womb.

Types of presentation of the fetus

There are three types of fetal presentation:

- when the axis of the fetus and the mother's uterus coincide and lie on the same line. Normally, there should be a head. When the baby is lying with its buttocks forward, it also complicates the process of childbirth.
Transverse - the baby is at a 90 ° angle to the mother's uterus. The head and buttocks are located on the sides above the ilium of the pelvis.
Oblique - when the child in relation to the mother is at a beveled acute angle, the head and buttocks are not on the same line. One part is on top, the other is on the bottom.

The doctor makes the final decision about the position of the fetus in the second half of the third trimester of pregnancy. Previously, this makes no sense, since the child can still take a normal position.

How is previa diagnosed

There are several ways to understand how the baby is located in the womb:

Screening ultrasound... The most popular method as the position of the fetus is immediately visible.
Palpation. The doctor finds the location of the baby and his body parts by touch.
Examination through the vagina.

An experienced doctor can identify abnormalities in the shape of the abdomen.

What is the danger of transverse presentation?

In medicine, there is a practice when specialists independently turn the child into the correct position by an external method. However, now such manipulations are used extremely rarely, since there is a high risk of complications for both.

The child, as a result of such a procedure, may develop serious injuries. In the mother, this can lead to rupture of the uterus. In addition, the fetus may suffocate, in which case even surgery will not help save it. Moreover, the procedure is quite painful.

After misbehavior is diagnosed and the fetus is fixed in the uterus, the doctor determines how the pregnancy and childbirth will proceed.

In the absence of contraindications, a special one is assigned to the pregnant woman, which helps to turn the fetus in the right direction. In addition, the doctor explains to the woman on which side it is better to lie in accordance with the position of the baby's head.

Here is one of the most common sets of exercises that can help your child turn in the right direction:

Lie on a hard surface, couch or sofa on either side and lie in this position for 5 minutes. Then slowly and carefully roll over onto the other side, and lie on it for the same amount. The sides need to be changed several times. It is recommended to repeat the procedure 3 times a day.
Lie on your back. Put a rolled blanket under the buttocks and lie for up to 10 minutes. Repeat also 3 times a day.
Get on all fours with support on your elbows and knees and stand that way for several minutes.

Such gymnastics will create favorable conditions for the child to take a normal position. However, you should consult your doctor before starting exercise.

Some elements of physical activity may be contraindicated for a pregnant woman due to health problems. The specialist will select gymnastics individually, taking into account the history and general well-being of the expectant mother.

Delivery with transverse presentation of the fetus

Transverse presentation is a great danger for both the pregnant woman and the fetus itself. If the situation does not change before the onset of labor, then it is not recommended to give birth on your own, since there is a high risk of complications.

Spontaneous childbirth is possible only when the baby's weight is very low or started early in pregnancy.

But it is important to take into account the level of uterine dilatation. Even if the baby's weight is acceptable, but the disclosure does not allow giving birth on its own, an urgent cesarean section will be required.

With a transverse presentation of the fetus, in most cases, a planned cesarean section is prescribed. At the 37th week of pregnancy, hospitalization is made and the expectant mother is prepared for surgery.

In the case of premature birth, doctors usually decide on an emergency operation, since a natural birth in this position is unacceptable.

Unlike oblique presentation, it is very unlikely that the child will take the correct position in the womb at the last moment.

A planned caesarean section is done on an empty stomach. Before the operation, the bladder and bowels must be emptied. Anesthesia is then administered.

Now it is made to choose from: general or. The second is the most popular because it has fewer risks to the health of the child. After the anesthesia has worked, the surgeon cuts and spreads the muscles, then the uterus, amniotic fluid and removes the baby.

Answer

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 the uterus coincide), transverse (when the axis of the fetus is perpendicular to the axis of the uterus), as well as oblique (the middle between the longitudinal and transverse).

The presentation of the fetus is determined depending on that part of it, which is located in the area of the internal os of the cervix, that is, in 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 defined.

Head presentation

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

With a head presentation, the pelvic end of the fetus can deviate to the right or left, it depends on which side the fetal back is facing.

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

Therefore, the anterior-cephalic presentation is a relative indication for a cesarean section. The next degree of extension is the frontal presentation (it is rare, in 0.04-0.05% of cases). With the normal size of the fetus, birth through the vaginal birth canal is impossible, prompt delivery is required. And finally, the maximum extension of the head is the facial presentation, when the face of the fetus is born first (it occurs in 0.25% of births). Vaginal birth is possible (while the birth tumor is located in the lower half of the face, in the lips and chin), but they are quite traumatic for the mother and fetus, so the issue is often decided in favor of a cesarean section.

Diagnosis of extensor presentations is carried out by 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 fetal legs are present, and gluteal presentation, when the baby seems to be squatting, and his buttocks are presented. more favorable.

Breech delivery is considered pathological due to the large number of complications in the mother and the fetus, since a less voluminous pelvic end is born first and difficulties arise when the head is removed. With a foot presentation, the doctor with his hand delays the birth of the child until he squats in order to prevent the prolapse of the leg, after such an allowance, the buttocks are born first.

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

the size of the fetus (with a breech presentation, the fetus is considered large over 3500 g, while in normal childbirth - more than 4000 g);
the size of the mother's pelvis;
type of breech presentation (leg or ligature);
the sex of the fetus (for a girl, giving birth in a breech position is associated with less risk than for a boy, since a boy may have damage to the genitals);
the age of the woman;
course and outcome of previous pregnancies and childbirth.

Transverse and oblique position of the fetus

The transverse and oblique position of the fetus is an absolute indication for a cesarean section; vaginal delivery is not possible. The presenting part is not defined. Such a situation is determined in 0.2-0.4% of cases. The previously used twists for the leg during childbirth are now not used due to the great trauma for the mother and baby. Occasionally, a similar turn can be used with twins, when, after the birth of the first fetus, the second took a lateral position.

The transverse position may be due to tumors in the uterus (for example,), which interfere with taking a normal position, in multiparous women due to overstretching of the uterus, with a large fetus, with a short umbilical cord or entwining it around the neck.

If there are no reasons that prevent the fetus from turning to the head, you can perform the same exercises as in the breech presentation. In an oblique position, you need to lie more on the side where the back is mainly facing.

Fetal position with twins

With twins, birth through the vaginal birth canal is possible if both fetuses are in a cephalic presentation, or if the first (which is closer to the exit from the uterus and will be born first) is in the cephalic presentation, and the second in the pelvic presentation. 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, babies can catch on with their heads.

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

Even with a favorable location 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 - fetal position. Personal impressions. Pregnancy and childbirth. bandage - fetal position. the doctor with my back advised me to buy and wear a bandage. but I have a child I know that in the later stages they do not recommend a bandage for breech presentation to give the child ...

Discussion

The doctor told me that the bandage does not fix the child's position. He is in the water, and there is still a lot of things around the child.
To really somehow "squeeze" the child, it is necessary to pull off the bandage with some incredible force, 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 is holding their tummy, but someone needs support in the form of a bandage?

Pregnancy, childbirth and breech presentation of the fetus. How to fix? Is natural childbirth possible with breech presentation of the baby? Ever since we were told at 30 weeks that we were lying upside down, I managed to redo a bunch of different exercises and get worried about ...

Discussion

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

I have a girl friend 14 years ago gave birth to a daughter in the pelvic. The doctors refused to do the KS: "second birth, you yourself will give birth." Result: the child has severe cerebral palsy.

Abnormal presentation of the fetus. The ideal position of the baby in the uterus is longitudinal with an 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 the ultrasound, the cephalic presentation, so I'm still wondering why she is so hammering there) of the abdomen so that slightly pushing the stomach from one hand to the other and back to determine whether the position of the fetus can be determined longitudinally by movement. In the place of his greatest activity ...

Discussion

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

it will grow a little more, and you can feel it :) you find such a concrete mound - this is a priest. from it, the back goes in such an arc to one side (it is very easy to determine), and the legs hang to the other side (if you press, you can find such small bumps, or just such uncertainties when everything is wrapped inward). and hairs are from hands and feet. and even from the priests with the head, on your term: o) but he still has time to settle down with his head down, do not worry!

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

Currently, the presence of a transverse position of the fetus in a pregnant woman in almost 100% of cases means that doctors will deliver her in the only way, namely with help.

Gradually, such a technique as turning the “fetus on its leg” during childbirth has “sunk into oblivion”. In addition, the external obstetric turn is performed less and less often. Whether this approach is overly cautious, or is it evidence of a dead end in midwifery, let's try to figure it out.

To understand the essence of the problem, it is necessary to understand what is called the "lateral position of the fetus"?

The normal position of the child in the womb is the longitudinal head position. In other words, the baby is positioned in such a way that the position of his torso and head coincides with the ovoid shape of the uterus. In this case, the head should be at the bottom, therefore it is called the presenting part (literally - “presented” to the bones of the woman's pelvis).

With a transverse presentation, the fetus is located across, which means that there is simply no presenting part. Also noteworthy is the oblique position of the child, in which the child's body is not across, but somewhat displaced. In this position, either the head or the pelvic end of the child is slightly lower.

But is the lateral position always a pathology? As you know, until the 30th week of gestation, the baby in the womb does not have a stable location. This means that only in the third trimester is it worth worrying about the wrong position of the fetus. All worries at an earlier date are simply useless.

What reasons can lead to the lateral position of the fetus?

Of course, in the physiological course of pregnancy in a healthy woman, the risk of developing such a complication is extremely small. And therefore, it is important to know the possible reasons leading to this complication:

With the localization of myomatous nodes in the region of the lower segment of the uterus, as well as cervical and isthmus nodes, there is a high probability that the fetus will take the wrong position. In addition, during pregnancy, some nodes begin to grow especially rapidly (with a proliferating variant of fibroids), which means that the tumor simply prevents the child from turning around correctly and adopting a physiological cephalic presentation.

Some abnormalities in the development of the uterus that interfere with the correct position of the baby in the womb.

For example, a septate uterus is two-horned.

It is also often the cause of this complication. The placenta, located in the region of the lower segment, is a serious obstacle to the adoption of a physiological position by the fetus.

With an increase in the volume of amniotic fluid, the child has the opportunity for excessive movement and turns around its axis. The baby does not feel the walls of the uterus, and this disrupts the work of his vestibular apparatus. As a result, the child takes on a wrong position.

If there is more than one fetus in the uterine cavity, then there is a high probability of their incorrect position, since the size of these babies is usually somewhat smaller than in a singleton pregnancy. In addition, it can happen, and babies sometimes do not have time to take a longitudinal position.

High birth parity.

After 4-5 births, the tone of the uterus is significantly weakened, therefore, during pregnancy, the overstretched muscular wall allows the child to make intrauterine twists and turns.

The first and second degree of narrowing usually does not interfere with the normal position of the fetus, however, with more pronounced narrowing of the pelvis, this can cause the baby to be transversely located.

In rare cases, the cause of the lateral position is the pathology of the vestibular apparatus of the child.

Simply put, the lateral position of the fetus can be in women with the following risk factors:

with tumors of the small pelvis;
narrowing of the bone ring of the pelvis;
abnormalities of the uterus;
with a weak overstretched abdominal wall;
after numerous surgical procedures (abortion, diagnostic curettage), which creates the risk of developing placenta previa during pregnancy.

What are the dangers of transverse presentation of the fetus?

This complication creates not only difficulties during childbirth, but also during childbirth, namely:

Risk of premature rupture of membranes.

This happens for the simple reason that there is no physiological separation of the amniotic fluid into anterior and posterior, which means that the lower pole of the fetal bladder is under increased stress and can rupture at any time.

The threat of premature birth.

Even if the amniotic fluid did not flow out, the likelihood of the onset of labor ahead of time is still high. There is an explanation for this: one of the theories of the onset of labor is that the fetus is under pressure from the uterus. And with the transverse position of the fetus, this happens early, since the uterus cannot quickly stretch.

The most dangerous complication is the prolapse of the arm or leg of the fetus after rupture of the membranes.

With a long stay of a small part of the fetus in the area of the exit from the uterus, there is a violation of its motor activity, which is called the "neglected" transverse position. In this state, the likelihood of intrauterine death of the baby is high.

Diagnostic methods

The transverse position is easy enough to diagnose:

With a vaginal examination, the presenting part is not determined, only the lower pole of the fetal bladder is palpated.
On external examination, you can see that the shape of the uterus is irregular, it is expanded in the central sections, taking the shape of the fetus.

Moreover, if you put your hands along the uterus, it is impossible to determine which side of the back, instead you can feel the head and pelvic ends.

With ultrasound, the position of the fetus at any stage of pregnancy is visualized most accurately. It is possible to reliably determine where the head and pelvic end are located.

Features of pregnancy management

Until the 30th week of gestation, you should not worry about the wrong position of the baby, since he himself can take the desired position at any time.

However, when diagnosing a transverse position after this period, the following rules should be adhered to:

given the high risk of rupture of the fetal bladder, a woman should more often be in a horizontal position;
do not perform unnecessary physical activity.

In order to correct the position of the fetus, a highly qualified obstetrician-gynecologist can perform external obstetric rotation of the fetus.

To successfully carry out this procedure, it is necessary to know well not only the position of the fetus, but its position (the location of the back). The doctor's task is not only to achieve a cephalic presentation, but also to prevent the formation of a posterior view (turning the back back).

This technique is not performed so often, because there are contraindications to it:

placenta previa;
pathology of attachment of the vessels of the umbilical cord;
multiple pregnancy;
the threat of premature birth;

Childbirth in the transverse position of the fetus

Due to the high trauma of childbirth in this position of the fetus for both the mother and the child, doctors try to fulfill such women.

However, sometimes women with this pathology enter the maternity hospital with active labor.

What options for the development of events can be during natural childbirth:

With a small position of the fetus, in rare cases, it takes a longitudinal position and is born without complications (extremely rare).
In premature babies, the following sometimes happens: moving along the birth canal, the fetus can bend "in half" and be born backwards.

This is usually accompanied by the death of the child, as multiple traumas and injuries occur.

The handle of the fetus falls out of the birth canal, which prevents natural childbirth from occurring.

Long-term presence of the baby leads to disturbances in his movements and "wedging" of the shoulder girdle into the region of the lower segment of the uterus. In this case, labor is enhanced, because the uterus is trying to "expel" the fetus. In the meantime, the lower segment becomes more and more stretched, which can cause the uterus to rupture. This condition threatens the life of the mother and fetus.

In rare cases, when the size of the fetus is small, the baby is turned on the leg.

It is called combined, because this technique consists in the fact that one hand of the doctor contributes to the rotation of the baby in the uterus, and the other from the outside directs his body in the right direction. More often this is done with multiple pregnancies, provided that the first child has already been born, and the position of the second fetus is transverse. But it is important to know that this operation is very traumatic and fraught with a high risk of complications (fetal death).

As you can see, the management of childbirth in such a pathology in a natural way is very dangerous and endangers the life of the child and the mother. Currently, the principles of gentle obstetrics are actively developing, in which such techniques as the combined turn are not justified.

Features of operative delivery

Considering all the difficulties and dangers in natural childbirth, it is not surprising that the transverse position of the child in the womb is an absolute indication for a cesarean section.

The most important condition for a successful outcome is to perform the operation as planned, when no complications have occurred.

Operation stages:

Dissection of all layers of the abdominal wall in layers;
Making an incision in the uterus;
The most important and difficult stage is the extraction of the fetus.

The doctor's hand grasps the leg of the fetus and it is transferred to the pelvic position, after which the fetus is completely removed by the pelvic end. The assistant assists the surgeon by guiding the baby's body from the outside.

Sometimes it is difficult to remove the child, as a result of which it is necessary to enlarge the incision in the uterus, and this, in turn, is dangerous by damage to the vascular bundles.

Removal of the placenta, curettage of the uterine cavity;
Restoration of the integrity of the uterine wall, examination of all organs in the abdominal cavity;
Sewing up the abdominal wall.

Case from practice
On one of the shifts, a woman was admitted to the maternity hospital with labor at 40 weeks. According to the woman in labor, the waters left her 8 hours ago, and the contractions have been going on for 2 hours. At the same time, the woman constantly complained of a foreign body in the perineal region.

On examination, it was revealed that the position of the fetus is transverse, and the baby's handle was visible from the opened cervix. At the same time, the fetal heartbeat was accelerated, reaching 180-200 per minute. As it turned out, the woman was not examined anywhere during pregnancy and was not registered, therefore, she did not know about the wrong position of the child.

Given the current situation, it was decided to carry out an emergency caesarean section. However, during the operation, difficulties arose in removing the fetus. At the same time, the incision in the uterus had to be enlarged.

Fearing to damage the vascular bundle, the surgeon increased the access not in the transverse direction, but slightly upward, in the form of a "smile". This helped to avoid damage to the uterine arteries and safely remove the baby. The baby was born weak, 5-6 points according to Apgar. But by the time he was discharged, his condition posed no threat.

The prevalence of operational tactics in the transverse position of the fetus is fully justified by the principles of careful obstetrics. This approach contributes not only to a decrease in maternal and child mortality, but also to the absence of adverse complications during delivery.

Less than 1 percent of pregnant women face this diagnosis. Today, transverse presentation of the fetus is a rare occurrence. If the expectant mother is diagnosed with a transverse presentation of the fetus, the reasons for this phenomenon will allow the specialist to determine how best to correct the situation.

The safest position of the baby in the uterus by the end of pregnancy is head down. If the pregnancy is proceeding normally, then the baby takes it on his own shortly before giving birth without outside interference. Every month, the woman's hips gradually expand, and the head enters the resulting hollow. In this case, the face of the fetus is turned towards the back of the mother. For such a natural position, the baby also has its own name: cephalic presentation. It is considered the safest and allows childbirth to pass without any complications.

But it happens that the child, for one reason or another, takes the wrong position in the uterus. This can be, for example, a foot or transverse presentation. The latter option assumes that the spine of the woman and the fetus are perpendicular to each other. If, with a foot presentation, natural childbirth is possible under the supervision of an experienced professional obstetrician-gynecologist, then with a transverse baby, a cesarean section will be born. After all, the child is located in the stomach across, and not along. He simply will not be able to independently get into the birth canal and successfully overcome them. Especially if the baby has a lot of weight.

The doctor will be able to determine the problem long before the birth. The baby actively rotates in the stomach and changes position until about 35 weeks. After this period, he begins to gradually prepare for birth and turn his head towards the "exit". The doctor will be able to diagnose "transverse presentation of the fetus" no earlier than 8-9 months of pregnancy. One of the main signs of this phenomenon is the unusual shape of the abdomen. It turns out to be transversely oval. If the child is large, then this is noticeable with the naked eye.

In addition, to make a diagnosis, the doctor palpates the belly of the expectant mother, feeling the baby's head and heels, listens to his heartbeat. If the crumb is located across, then the beat of his heart will be heard exclusively in the navel.

If, after a thorough examination, there are doubts about the diagnosis, an ultrasound examination may be prescribed for the fair sex. It is this that will allow you to accurately determine the position of the fetus. Modern ultrasound equipment makes it possible to diagnose the problem quickly and easily without a vaginal examination.

In rare cases, various pathologies of its development become the cause of the transverse presentation of the fetus. For example, among them is cerebral edema or underdevelopment of its hemispheres. These ailments do not allow the baby to take the correct natural position in the uterus.

You can name a variety of reasons for the phenomenon under discussion. First of all, low water or polyhydramnios stands out among them. If there is too little amniotic fluid, then it is difficult for the child to move and change position, since it is squeezed by the walls of the uterus. In the opposite case, it is more difficult for the baby to sit head down and stay in this position, because there is a lot of free space inside the abdomen and he can actively "swim" until the very birth.

Another common cause of the problem is weakness in the muscles of the peritoneum and the walls of the uterus. Most often, in this way, circumstances develop in women who have gone through more than one childbirth. The natural shape and location of the uterus, improper placement of the placenta, or any neoplasms inside the organ (polyps, tumors, adenomas) can affect the child's posture.

Surely all expectant mothers are interested in knowing what the danger of transverse presentation of the fetus is. In general, pregnancy under these conditions can proceed normally. Only in the last couple of weeks will a woman suffer from pain in the hips and lower back, severe fatigue, shortness of breath, etc. At 8 and 9 months, a girl with this problem should be under constant medical supervision. Best of all - in a hospital.

Indeed, with a transverse presentation of the fetus, there is a high risk of premature birth. In some cases, uterine rupture occurs and uterine bleeding begins. If a woman lives far from the hospital, then in the event of a dangerous pathology, specialists simply will not have time to help her.

Also, the list of risks includes oxygen starvation of the baby, the loss of parts of the baby's body from the uterine cavity during childbirth, the death of the baby or the patient herself. Therefore, it is so important that in the last months of pregnancy a woman with a transverse presentation of the fetus closely monitors her condition and observes all the doctor's recommendations.

In most cases, the gynecologist sends a patient with an existing pathology for a cesarean section. Only an experienced doctor can decide to give birth naturally. At the same time, he will take responsibility for the life and health of both the mother and the baby. Natural childbirth is possible only with a small weight and size of the child. The physical condition and individual characteristics of the woman's body will also be taken into account.

After the diagnosis of "transverse presentation of the fetus", the woman should try to provoke the child to turn into the correct position on her own. This can be done using special exercises. The main thing is to do them regularly.

Modern medicine allows a baby to be born healthy and strong, no matter what position they were in for all 9 months. If a woman is prescribed a cesarean section, there is no need to give up such a procedure and insist on natural childbirth. The operation will protect mother and child from possible dangerous injuries.

Every woman wants her pregnancy to proceed without complications and end with the birth of a healthy baby. But sometimes it happens that the gestation period has its own characteristics that can affect the health of the mother and child. One of these features that complicates childbirth is the transverse presentation of the fetus.

Causes and complications

The named pathology of pregnancy occurs approximately once in 200 cases (0.5-0.7%). It happens more often with repeated pregnancies. It is determined after 32-34 weeks. Before that, the fetus is quite mobile and often changes its location in the uterus. And at 33-34 weeks, the child is placed in a certain position, preparing for the upcoming birth. There are three provisions that a child can take after the named period:

longitudinal (the fetal body is placed along the uterine cavity, addressing the birth canal with the head (head position) or buttocks (gluteal position). The longitudinal position is considered normal and is typical for more than 99% of pregnancies);
transverse (the baby is located across the uterus, large parts of the fetus are felt on the right and left sides of the uterus);
oblique (the baby's body is located at an acute angle to the longitudinal axis of the uterus).

There may be several reasons for the manifestation of a pathological presentation (transverse or oblique). This is polyhydramnios and oligohydramnios, multiple pregnancies, too narrow a pelvis, pathologies of the structure of the uterus or some of its diseases (for example, with myoma, nodes on the muscle tissue of the uterus prevent the child from positioning correctly). The wrong position also happens in babies with developmental pathologies or too large a body weight.

As already mentioned, transverse presentation is characteristic of the second and subsequent pregnancies. There is a simple explanation for this. The muscles of the anterior abdominal wall stretch from the pressure of the growing uterus, become flabby and can no longer restrain the movement of the fetus. Therefore, it turns incorrectly.

In most cases, transverse presentation pregnancy is normal. Although in a third of such cases, childbirth begins prematurely with premature rupture of amniotic fluid. If, in addition to this, there is also such a pathology as placenta previa, then severe bleeding may occur.

With transverse presentation, complications are possible during natural childbirth. For example, prolapse of the umbilical cord or limb (arm, leg) of the fetus. This can cause infection of the amniotic fluid and inflammation of the membranes of the fetus (chorioamnionitis), provoke sepsis.

Premature rupture of amniotic fluid and prolonged "anhydrous" stay of the fetus can lead to hypoxia (lack of oxygen) or even asphyxia (suffocation).

With a transverse presentation, it is extremely rare, but births with a "double body" also occur. After the discharge of amniotic fluid and during intense contractions, the walls of the uterus press so hard on the fetus that it bends in the thoracic region. In this case, childbirth ends spontaneously. First, the chest comes out with the neck pressed against it, then the stomach with the head pressed against it, after that - the buttocks and legs. Such births occur with a large prematurity or a dead fetus.

Sometimes, with a transverse presentation during childbirth, the baby itself turns into a normal position, taking the head or gluteal position.

What is the neglected lateral position of the fetus?

Quite often, with transverse presentation in childbirth, a complication occurs, which is called the neglected transverse position of the fetus. Its essence is that after the premature discharge of the amniotic fluid, the baby's mobility is limited, his shoulder and hand are "hammered" into the pelvic bone, blocking the movement of the head and trunk to the birth canal.

This complication can cause the uterus to rupture. To prevent him, a cesarean section is performed.

How to correct transverse presentation

Once transverse presentation, as a rule, ended fatally for both the mother and the child. Now this risk is minimized. The wrong position of the fetus is determined during a routine examination by a gynecologist, the doctor presses lightly on his stomach with his fingers and determines where the parts of the baby's body are. During the ultrasound, the incorrect position is confirmed. To correct it, pregnant women are often asked to perform simple exercises that should stimulate the baby to take the correct position. However, it should be said that they do not help everyone.

Exercises for transverse presentation of the fetus

Special exercises should be done several times a day, for at least a week.

Lying on a bed or sofa, make three or four turns from side to side. You need to lie on each side for 5-7 minutes, then turn over.
Lying on your back, lift your buttocks above the level of your head. You can put a rolled-up blanket or pillow underneath. In this position, you need to lie down for 5-7 minutes.
Cat pose: kneel down, rest your hands on the floor, inhale and raise your head and tailbone, arching your lower back, while exhaling, lower your head and arch your back.
Get on your knees, rest on your elbows (pelvis above your head). Stay in this position for 5-7 minutes.

As you know, in the late stages, sleeping on your back is not very comfortable, and even not desirable. After all, a large enough fetus presses on the vena cava and on the internal organs. Therefore, pregnant women are advised to sleep on their side. With the transverse position of the fetus, it is advised to turn to the side where the baby's head is. Although the expectant mother must determine for herself how it is more comfortable for her to sleep. If you feel uncomfortable, you can change your position.

For a more comfortable position, you can place a rolled blanket or a maternity pillow under your belly or back.

Is it possible to wear a bandage with transverse presentation

Often in the second half of pregnancy, women are advised to wear a bandage. This helps to reduce stress on the spine, back muscles and internal organs. However, in transverse presentation of the fetus, wearing a bandage is not recommended. After all, he fixes the position of the child in the womb, which means that he does not allow him to turn and take the correct position. If the child has turned from the transverse to the longitudinal position, the doctor may recommend wearing a bandage to fix this correct position of the baby.

Childbirth in the transverse position of the fetus

The position of the fetus is decisive for the management of childbirth. If the child has not turned over and lies across the uterus, then natural childbirth is impossible, as it can have dangerous consequences that threaten the life of the baby and his mother.

In such cases, a planned caesarean section is performed. At the 37th week, a woman goes to the hospital and prepares for this procedure. It is performed under general or local anesthesia.

If childbirth begins prematurely, then an emergency caesarean section is performed to avoid dangerous consequences.

Specially for -Elena Semenova