What does it mean if the fetus is in breech presentation. Breech presentation of the fetus. Delivery with breech presentation of the fetus

06.09.2019

Breech presentation is observed in 6% of pregnant women. During normal pregnancy, the baby is in the right place by the 21st week of gestation. But due to the presence of a number of negative factors, it can remain unchanged until the 3rd trimester.

The abnormal position of the fetus is not dangerous until 22 weeks of gestation. During this period, it is likely that the child's seat will turn over in the womb several more times, but if the pathology is observed at a later date, it is dangerous for both the child and the mother.

What does breech presentation of the fetus mean?

Breech presentation is the position of the embryo in the lower part of the uterus, near the fallopian tube. During gestation, the child should be head down, but in some situations it is able to change the position, and the buttocks or legs are below. This pathological condition is most often detected at 25 weeks of embryo development. With a breech presentation of a full-term fetus, the worst prognosis is the death or severe injury of the baby at birth.

Improper placement of the baby in the womb may be due to diseases of the uterus, a small amount of amniotic fluid, or a weak placenta. You can understand the development of pathology by the nature of the baby's movements. Most often, such a deviation is the cause of premature labor or with the help of a cesarean section. The disease is treatable, which means that there is a chance to leave the baby safe and sound.

Possible causes of the problem

Why does such an anomaly occur?

Doctors identify the following reasons for the improper position of the baby:

Due to the high water, the mobility of the embryo increases, so there is a possibility that it can assume an oblique position.
With high water, the baby cannot fully move and when changing the position, there is a small chance that he will again get into the right place.
When a woman is carrying twins, there is less space in the womb. Babies get cramped and one of them may look for a more comfortable position and therefore turns his head up.
The narrow pelvis of the expectant mother.
Abnormal position of the placenta (along the anterior wall).
The baby is too big.
Myoma of the uterus.
Pathological condition of the ovaries.

If a woman does not have uterine diseases, the placenta is healthy and the embryo develops normally, then there is a chance to avoid high water or low water in the womb. A decrease in fluid is observed as a result of previous abortions, diseases of the genital organs, multiple fertilizations and with problems that arose in a previous pregnancy. In addition, there is a special corrective gymnastics that can help the baby to get into the correct posture.

Diagnostic measures

To identify pathology, two types of diagnostics are used: external obstetrics and vaginal examination. During an external examination, the doctor determines the position of the child, the soft and inactive part of the placenta by the movements. In addition, in this way, an increased standing of the fundus of the uterus is revealed, which may not correspond to the trimester of gestation. The doctor determines the baby's mobility and listens for the heartbeat by listening to the baby in the navel area with a stethoscope.

A vaginal examination of the patient helps to identify a soft and voluminous part with a gluteal abnormality. In this way, it determines where the sacrum, coccyx and inguinal fold in the baby are located. If the girl has a mixed or foot presentation, then the doctor will detect movement of the child's foot.

In addition, ultrasound will help to make an accurate diagnosis of the wrong position of the baby. It will show the location of the fetus and help determine the type of pathology. During the study period, the doctor also determines the posture of the head, since if the presentation is incorrect, there may be complications at birth (the infant may have a damaged cerebellum or cervical spine).

How is the pregnancy going?

The head and pelvic transverse presentation with a mild degree of development does not interfere with the management of pregnancy, it proceeds normally without complications. The girl does not feel discomfort, pain or heaviness either at 10-19 weeks or at a later date. At 33 weeks, a woman is prescribed a special set of exercises that will help change the position of the fetus and facilitate childbirth.

The most commonly prescribed exercise is:

You need to take a recumbent position on the bed.
Turn alternately on the right and left sides with an interval of 15 minutes.
Repeat the exercise 4-5 times in each direction.

Charging in a pathological condition is done 3-4 times a day. With a systematic exercise, the fetus turns its head downward for 7-9 days, if there are no complications. The goal of gymnastics is to increase the excitability of the walls of the uterus. And also the woman is recommended to sleep on her side. If by the end of gestation no changes are visible, then the girl is hospitalized 1.5-2 weeks before the birth of the baby. This is a mandatory procedure for all pregnant women in whom an ultrasound scan showed the disease. The pregnant woman is put on preservation in order to find out exactly how the baby will be born (naturally or with the help of cesarean).

How is labor in breech presentation

How exactly the birth of the baby will take place is decided by the attending physician.

Whether a cesarean is prescribed depends on the following factors:

The age of the girl (after 35 years, natural childbirth can provoke a number of complications).
The size of the pelvis.
The course of pregnancy and its timing.
The body weight of the child and the fetus (if a girl, then, most likely, it will be a cesarean, a boy is a natural child).
The diameter of the vagina.

Most often, problems with childbirth arise due to the immaturity of the vagina, late drainage of waters, vaginal pathologies, fibroids and a difficult period of gestation.

If the baby is born naturally, then before the contractions to relieve tension and minimize muscle spasms, the woman is injected with anesthetic. He is driven when the cervix opens up to 40-50 mm.

Due to the abnormal development of the disease during natural childbirth, the following complications may occur:

late discharge of water;
prolapse of the umbilical cord loop and placenta particles;
development of uterine abnormalities;
labor is delayed;
the appearance of acute hypoxia;
premature detachment of the child's place from the walls of the uterus.

Such complications are dangerous for the fetus and the mother, so the birth takes place under the supervision of obstetricians. After the waters have departed, doctors examine the vagina to find out if the woman in labor will be able to give birth to the baby herself. If there is a loss of loops, then a cesarean section is done.

Most often, childbirth with this diagnosis proceeds normally, but there is a high risk of complications and problems. Therefore, it is important for a girl in a position to take preventive measures to facilitate childbirth.

Is it possible to eliminate the pathological position of the fetus

If the disease develops in the early stages or is mild, there is a chance to eliminate the problem. Preventive gymnastics and medication will come to the rescue.

The main measures that can eliminate the disease include:

In the second trimester of gestation, antispasmodic drugs are prescribed. They are taken at half the permissible dose 3-4 times a week.
The condition of the muscles of the uterus is monitored. Drugs may be prescribed to relieve nervous excitement.
Gymnastic exercises. A complex of movements will help to change the incorrect placement of the embryo. All classes are held in a sitting or lying position for 15–20 minutes. They need to be performed half an hour before a meal. All actions are performed in compliance with the doctor's recommendations.
Bandage. The belt will help support the abdomen and relieve tension from the back, the muscles will be more relaxed, which will help the embryo move more actively.
Sometimes an external transfer of the child to the head is used. But this method of treatment is quite dangerous, as it can harm the fetus and cause complications (hypoxia, trauma to the baby, premature birth).

The real story in this video:

How doctors can help

When diagnosed with oblique breech presentation, doctors can provide a woman with several types of assistance.

Correction of a pathological condition before the birth of a child

The detection of pathology is not always negative. There are times when there is a chance to rectify the situation. If the disease was detected at 32–34 weeks of gestation, then doctors prescribe a special course of gymnastic exercises for the pregnant woman. Exercises can be performed at home, but during the period of therapy, you need to systematically visit a gynecologist in order to minimize the risks of developing the disease.

This method of treatment is contraindicated if a woman has:

narrow pelvis;
there is a possibility of premature birth;
there were miscarriages or turnovers in a previous pregnancy;
a lot / little amniotic fluid;
diseases of the uterus;
2 or 3 fetuses in the womb;
preeclampsia;
diseases that prohibit exercise therapy.

Despite the fact that the method has many contraindications, it is very effective and in the early stages of gestation helps the baby to roll over. But in this case, one cannot engage in self-medication, this threatens an even greater deterioration in the situation. All activities must be supervised by a specialist.

Obstetric twist

If the deviation was detected at 6-7 months of pregnancy, then you can make an obstetric turn. The doctor carries out certain mechanical manipulations that help the fetus to turn its head down. Such an action can only be performed by a qualified specialist in a medical institution under the supervision of an ultrasound machine. It helps to monitor the child's condition and track his upheaval.

Before doing the procedure, the girl must undergo certain training. Do not eat at night before the procedure, as it is only done on an empty stomach. In addition, the bladder is emptied and muscle-relaxing drugs are injected intramuscularly. This will reduce the risk of cramping and make the procedure less painful. The obstetric turn is allowed only for certain types of the disease and in the early stages of pregnancy. If the fetus is not in place by the end of pregnancy, then a cesarean is prescribed.

Caesarean section with breech presentation of the fetus

Caesarean is done to make the baby easier to retrieve. With it, the risks of complications are minimized. Most often, it is done if the girl has a narrow pelvis, and the natural birth of a baby is dangerous for the life of two, or the biomechanism of childbirth is impaired.

In addition, the location of the fetus plays an important role. If, with his presentation, it is impossible to give birth on his own, then a cesarean section is performed. The operation prevents possible problems and protects the uterus from damage. The doctors' comments indicate that this is the safest option when staging with such an anomaly.

Conclusion

Breech presentation is observed due to many factors that can negatively affect the fetus and the expectant mother. In the early stages of development, the problem can be eliminated, pregnancy and childbirth will proceed normally.

But there are times when the pathological position of the fetus causes a number of complications and becomes a threat to the life of the mother and child. Therefore, if there are signs of improper location of the baby, you should go to the hospital and undergo a medical examination in order to prevent unwanted consequences.

When a pregnant woman finds out that the baby in the tummy is located with the buttocks or legs down, she begins to worry, because it is wrong. Breech presentation of the fetus is usually diagnosed by 32 weeks of gestation at the next visit to the antenatal clinic. But this situation does not always persist until childbirth, because the child is able to change his position. In addition, there are a number of measures through which you can "turn" the fetus, giving it the correct position.

What is breech presentation of the fetus?

The fetus in breech presentation is located in the uterus, head up... It turns out that the baby's pelvis is at the bottom, and this is non-standard for natural delivery. Such births occur in 3-5% of cases and are pathological, since the baby can be injured or complications are possible. This diagnosis is made after 32 weeks of pregnancy. The baby in the mother’s tummy is in free swimming and can turn over several times.

Classification of breech presentation of the fetus

Baby in the uterus may have the following location:

Leg - the thighs, one or both, are unbent, and one leg is located at the exit from the uterus. This arrangement is found in pregnant women in 10 - 30% of cases.
Glute - the child's legs are bent at the hip joints and pressed against the tummy. This presentation is observed in 50 - 70% of women.
Mixed (gluteal-leg) - hips and knees bent. There is a similar situation in 5-10% of cases.

Although with such an arrangement, birth is possible naturally, but still often shown... If such childbirth does occur, then they require constant and enhanced medical supervision, because complications may arise.

Causes

Usually, up to 31 - 32 weeks of gestation, there is a lot of room for fetal movement in the uterine cavity. The child usually takes a head-down position as he grows. Breech presentation of the fetus at 32 weeks of gestation occurs in 25% of cases, and closer to delivery it decreases to three percent. Therefore, if premature birth occurs, then the likelihood of an incorrect position of the child is high.

Breech presentation of the fetus is due to several factors. The main reasons are irritability of the uterus and decreased tone... In addition, this situation is facilitated by:

abnormalities in the development of the uterus;
some fetal malformations;
the presence of multiple pregnancies;
lack of water or polyhydramnios;
placenta previa.

Signs

Physically, a pregnant woman does not feel such a pathology in any way. She is not worried about discomfort or pain syndrome, which can warn about the incorrect position of the baby in the uterus. This position is determined only during examination... At the same time, the baby's heartbeat in the navel area is much more clearly heard.

Such signs come to light during a vaginal examination. For example, in the gluteal position, the doctor probes the groin fold, the soft volumetric part, the sacrum and the tailbone. With a mixed leg and gluteal position, the child's feet are determined with a heel tubercle and toes that are located in one line. To clarify the diagnosis, an ultrasound scan is required.

A baby in the pelvic position can be delivered naturally or with a caesarean section.

Choosing a method of delivery depends on factors such as:

Birth with a pelvic baby can be natural if:

gestational age more than 37 weeks;
average fruit weight - 2500 - 3500 g;
the pelvis is of normal size;
the future child is a girl
presentation is breech or breech-leg.

In all other cases, surgery is required. Sometimes, during a natural childbirth, the doctor decides to perform a cesarean section, which called emergency... Indications for immediate surgery are:

falling out of the baby's arms or legs, as well as the umbilical cord;
placental abruption;
weak labor activity;
fetal hypoxia.

Possible complications

Breech presentation of the fetus does not affect the course of pregnancy at all, but serious complications can occur during childbirth.

First, it may be weak labor. This condition occurs due to the fact that the pelvic end is much smaller in terms of the volume of the head and less pressure on the uterus, which begins to shrink worse.

Secondly, during childbirth, the baby's head may tilt back, and it can hardly come out. There is a great risk of injury to the child.

Thirdly, in breech presentation, the umbilical cord is usually clamped between the head and the wall of the birth canal. This leads to obstruction of oxygen flow, causing hypoxia in the fetus.

Fourth, during childbirth, the handles can be thrown back, which can lead to injuries.

How to correct the wrong position of the fetus?

Many pregnant women start to panic very early when they find out that their baby is in the wrong position in the tummy. Ultrasound at 21 or 22 weeks pregnancy usually already shows what position the fetus has taken and if it is pelvic, then women begin to look for methods that would correct this condition. But it is too early to think about it. But if an ultrasound scan at week 32 showed an incorrect position of the fetus, then it is recommended to perform special exercises. Thanks to them, in most cases, the child takes the head position.

Exercises should be performed from the 32nd week of pregnancy, but only if it proceeds without complications, otherwise you can harm the baby. All classes should begin with a warm-up. A woman should walk with her usual pace for several minutes, after which she should walk on her heels and toes. The arms can be rotated, raised and lowered, and the knees can be raised to the side of the abdomen. Below are simple exercises that are recommended after 32 weeks of pregnancy if the baby has a breech presentation.

Exercise 1

You need to stand up, straighten your back and spread your legs. The arms should hang freely along the torso. Necessary stand on tiptoes, spread your arms to the sides, bend your back and inhale. Then you should exhale and stand up to the starting position. This exercise must be performed 4 to 5 times.

Exercise 2

In this case, pillows will be required to be used to lift the pelvis. A pregnant woman should lie on the floor and place pillows under her pelvis, which should rise 30 to 40 cm above shoulder level. Keep your shoulders, knees and pelvis in a straight line. This activity is recommended to be performed twice a day for five to ten minutes on an empty stomach.

Exercise # 3

You should lie on your back, bend your legs and spread them shoulder-width apart. You need to rest your feet on the floor. Relaxed arms are extended along the body. Then you need to take a breath raise your back and pelvis, and when you exhale, you need to take the starting position. After that, the legs are straightened, inhale, drawing in the stomach. The muscles of the buttocks and perineum should be tense. When you exhale, they again take their starting position. This exercise is recommended to be performed 6 - 7 times.

In addition to exercise, outdoor exercise and proper nutrition can affect fetal position. Pregnant women should sit on chairs with a hard back and a hard seat. If you have to sit on upholstered furniture, you should spread your legs a little so that your stomach is free. You can also buy fitball to perform special exercises on it that can change the breech presentation of the fetus.

Ultrasound and medications

If such methods did not bring the desired result, then the doctor may offer the woman in the position an ultrasound procedure and medication. It is recommended to carry it out no earlier than 34 weeks of pregnancy with the use of special medicines. Such a procedure is rather complicated, but very effective, after passing which a woman has the opportunity to give birth naturally.

This procedure has contraindications:

obesity;
entanglement of the fetus with the umbilical cord;
preeclampsia;
scars on the uterus;
the age of the primiparous woman is more than 30 years old, etc.

This method is not suitable for everyone during pregnancy, so it is rarely used in obstetrics and gynecology.

Thus, one should not panic upon learning that the child is in breech presentation. Before giving birth, he will be able to change his position several times. From 32 weeks you can perform special exercises, but only in the absence of contraindications. If the baby continues to be in breech position, the doctor will select the best delivery option.

Until a certain point, the baby in the womb moves freely. However, as he grows, it becomes cramped. For this reason, he takes a certain position and remains so until the very birth - in most cases, head down. But it also happens that he takes the opposite position, which is called the breech presentation of the fetus. What are its features? Is there any way to fix this?

Classification

Breech presentation of the fetus is of two types: gluteal and leg. Each of the species is divided into subspecies.

Buttock

Pure gluteal. It occurs in about 75% of cases of this type of situation. The child's buttocks are turned towards the small pelvis. His legs are along his body.
Mixed. The legs of the fetus are bent and "look", like the buttocks, towards the exit from the uterus. This situation is observed in 20-24% of situations.

Foot

Experts call the foot presentation of the fetus the most dangerous. It provokes the prolapse of the umbilical cord or limbs of the fetus, as well as asphyxia during childbirth.

If simple breech presentation is observed, problems usually do not arise. If the expectant mother has sufficient pelvic size, the birth will take place without complications.

Why does this feature appear?

Breech presentation occurs for various reasons, often doctors cannot name exactly why. Most often, you can find several reasons:

Myoma of the uterus. The one that formed in the lower part of it has a special influence.
Abnormal development or shape of a woman's pelvis.
Tumors of the ovaries and other organs located in the small pelvis.
Hydrocephalus, cephalocele (cranial hernia) and other disorders in the development of the child's brain.
Incorrect placement of the placenta - too low position.

Not the least among the reasons provoking this phenomenon is the hypertonicity of the lower part of the uterus and the low tone of its upper parts. In such conditions, the fetal head is pushed away from the pelvis, and the baby is turned upside down. This is often due to changes in the myometrium (muscle tissue of the uterus). They happen due to inflammation, scrapings, multiple pregnancies, or difficult births in the past. Another reason for such changes is the presence of scars, for example, after a cesarean. Sometimes breech presentation is passed from mother to daughter.

If a woman was born in this position herself, there is a high probability that she will also encounter it during her pregnancies.

Perhaps there is some genetic predisposition, but this issue has not yet been fully understood. It is rather difficult to establish the reason why a breech presentation appears. In almost all cases, there are two or more of them. Doctors identify several categories of women who may develop breech presentation.

Usually they suffer from any diseases or disorders in the body:

The pelvis is too narrow.
Disturbances in the development of the uterus or its changes due to internal or external influences. It can be a bicornuate uterus, fibroids, hypoplasia, inflammation, scars.
Neoplasms in the pelvic organs.
Diseases of the autonomic nervous system.
Abortions, difficult childbirth, curettage, etc.
Insufficiency of the placenta and conditions that arise from it. These are oligohydramnios or polyhydramnios, lack of oxygen (hypoxia) and developmental delay.

Complications

Breech presentation is fraught with many dangers. Most often, there is a threat of termination of pregnancy in late stages, gestosis and placental insufficiency. These conditions lead to fetal hypoxia, disturbances in its development, the wrong amount of amniotic fluid and entanglement with the umbilical cord.

In addition to the above, the following complications are possible:

By 37-40 weeks of gestation, a lag in the development of the medulla oblongata appears. The work of the pituitary gland is disrupted.
After birth, the child will not be able to quickly adapt to external conditions. Reduced anti-stress resistance.

Hemorrhages occur in the ovaries and testicles of the fetus. Sometimes tissue edema appears, leading to the death of germ cells. All this leads to diseases such as azoospermia (severe infertility in men), hypogonadism (a decrease in the level of sex hormones, leading to testicular failure), etc.
Disruptions in the development of the nervous system, gastrointestinal tract and musculoskeletal system.
Little oxygen is supplied to the child.
The fetal heart rate increases.
In especially difficult cases, cerebral palsy may develop.
The child cannot move normally. In most cases, he only occasionally moves his limbs.

Diagnostics

The breech presentation can be most accurately determined by 34-35 weeks of gestation. This is done by an external obstetric and vaginal examination.

The doctor sees that the height of the fundus of the uterus does not correspond to the gestational age. At the entrance to the pelvis, it is not the head of the fetus that is felt, but its buttocks or legs. The heart is heard in the region of the navel or slightly above it. With a vaginal examination, the feet, groin fold, sacrum and tailbone can be identified.

The easiest way to identify the foot presentation. To obtain more accurate data, it is recommended to do an ultrasound scan. Thanks to this study, you can determine the type of presentation. Sometimes dopplerography and CT scan are additionally prescribed.

Is it possible to eliminate the pathological position of the fetus?

The answer is yes: you can. Treatment methods include gymnastics, the use of drugs, and control of the general condition of the body:

For a period of 22-24 weeks, the doctor may prescribe antispasmodic drugs. They need to be taken several times a week at half the usual dose.
Monitoring the condition of the muscles of the uterus. Removal of nervous excitement.
Exercise to help reposition the fetus. One of them involves turns while lying on the right and left side. You need to do this exercise three times a day before meals. Charge for about 10 minutes.
In some cases, an external overturn of the child on the head is shown. However, this method has questionable effectiveness. It can lead to unpleasant consequences such as premature birth, fetal hypoxia, and injury.

Features of medical support

Breech presentation requires special attention of the doctor to the pregnant woman. At 38-39 weeks, she is offered to go to the clinic for additional examination, to determine the date and method of childbirth.

The research consists of several stages:

A careful study of the woman's medical history, her past pregnancies and childbirth.
Study of the general condition - both physical and emotional.
Clarification of the gestational age by the date of the last menstruation and ultrasound.
Determination of the type of pathology, the preparedness of the cervix for childbirth and the state of the placenta and fetal bladder.
Finding out the size of the pelvis.
Assessment of the child's condition. This includes determining its weight, the amount of amniotic fluid, the presence of developmental disorders, etc.
Determination of the degree of extension of the child's head and gender. It is known that it is more difficult for boys to cope with childbirth stress.

Based on the results of the study, the method of delivery is selected.

It is influenced by several parameters:

woman's age;
the diseases she suffered;
the readiness of the cervix and the whole body as a whole for childbirth;
the size of the pelvis;
the child's condition, weight and gender;
type of presentation.

Delivery can be natural or by caesarean section. Both must have their own testimony.

Caesarean section is performed if:

foot presentation;
mixed breech presentation (with the first childbirth);
fetal weight up to 2 kg or more than 3.5 kg;
low location of the placenta;
enlarged veins in the genital area;
insufficiently wide pelvis;
preeclampsia;
uterine fibroids;
abnormal development of the uterus, for example, a two-horned uterus;

unavailability of the cervix;
scar on the uterus;
exceeding the gestation period;
primiparous over thirty years old;
problems with past pregnancies (premature birth, stillbirth, child injuries during childbirth);
pregnancy as a result of in vitro fertilization.

sufficient size of the pelvis;
satisfactory condition of both the woman and the fetus;
the preparedness of the mother's body for the birth of a child;
exclusively breech presentation.

If the choice fell on natural childbirth, the pregnant woman needs to be prepared for them. Preparation includes taking sedatives, antispasmodics and restorative drugs. It is very important that a doctor supervises the medication process.

You need to prepare the cervix before giving birth. For this, special injections and gels are used to be inserted directly into the vagina. If the cervix has not opened even after preparatory measures, doctors are inclined to carry out surgery.

Breech presentation is not a sentence. If there are no contraindications, a woman can give birth naturally. However, if there is a threat to the life of the mother or child, it is better to choose an alternative method of delivery.

Expectant mothers, having learned from the doctor that their baby is located in the tummy with the head up, begin to worry, because this position of the fetus is considered incorrect. It is called breech presentation. The baby in the uterus should be positioned with its head down as it represents the widest part of the fetus.

It is best if the head appears first during childbirth, and then the rest of the body. However, 3-5% of women have childbirth with breech presentation of the fetus, which is fraught with complications.

The location of the child in the uterine cavity is classified as follows:

Foot- both hips are unbent or only one of them, and one leg is located at the exit from the uterus. This type of presentation is observed in 10-30% of pregnant women (most often in multiparous women).
Buttock- the legs of the fetus in the hip joints are bent, and the knees are pressed to the tummy and straightened. This presentation occurs in 50-70% of women in position (most often in primiparous).
Mixed(gluteal leg) - knees and hips bent. This type of presentation occurs in 5-10% of cases.

Causes of breech presentation of the fetus

Until 32 weeks, the fetus can take various positions in the mother's tummy. The presence of free space in the uterus allows it to move. As the child grows, he tends to sit with his head down.

For the following reasons, breech presentation of the fetus may persist until delivery:

lack of water or;
pathology of the placenta: location in the area of the tubal corners,;
pathology of the uterus: violation of tone, fibroids;
fetal pathology: anencephaly, hydrocephalus;
multiple pregnancy;
the consequence of a cesarean section.

Signs of a breech presentation of the fetus

Many women are concerned about the question of what the breech presentation of the fetus means, and by what signs it can be determined. Pregnant women do not feel at all that their baby is lying incorrectly in the uterus. There is no discharge or pain. Breech presentation can only be determined by a doctor during examination.

Experts note that when the child is placed head up, there is a higher standing above the pubis of the fundus of the uterus, which does not correspond to the gestational age. In the area of the navel, the fetal heartbeat is heard more clearly.

With a vaginal examination, the doctor may reveal signs of a breech presentation of the fetus. With the mixed and foot position of the child, his feet are probed, and with the gluteal position, the sacrum, the inguinal fold, the soft volumetric part, the tailbone. Despite all the signs, an accurate diagnosis is determined only by ultrasound.

Delivery with breech presentation of the fetus

A baby can be born in a breech presentation naturally or as a result of a cesarean section.

The choice of a specific method of delivery depends on the following factors:

the age of the pregnant woman;
gestational age;
history data;
existing diseases;
the size of the pelvis;
type of breech presentation;
the sex and weight of the fetus, the degree of extension of its head.

Delivery with breech presentation of the fetus can take place naturally if: the gestational age is more than 37 weeks; the average estimated weight of the fetus is 2500-3500 g; the size of the mother's pelvis is normal; it is known that a girl will be born, not a boy; presentation is gluteal or gluteal-leg presentation.

If the above conditions are not met, then it is required. In addition, the operation is necessary if: delivery is premature; the weight of the fruit is less than 2500 or more than 3500 g; male fetus; breech presentation is foot, ultrasound revealed hyperextension of the fetal head.

Your doctor may decide to have a caesarean section once you start to give birth naturally. It will be called emergency. Indications for immediate surgery may be as follows:

weak labor activity;
falling out of the baby's legs, arms or umbilical cord;
discoordination of labor (contractions are observed, and the cervix does not open).

Possible complications during childbirth with breech presentation of the fetus

Breech presentation of the fetus in the longitudinal position has absolutely no effect on the course of pregnancy. Complications can occur during childbirth.

First, labor may be weak. This is due to the fact that the pelvic end of the fetus is smaller than the head in volume. He weakly presses on the uterus, and as a result, it contracts worse, its cervix opens more slowly.

Secondly, during childbirth, the baby's head may tilt back. Her birth will be difficult. There is a risk that the child will be injured.

Thirdly, often with a breech presentation of the fetus, the umbilical cord is clamped between the wall of the birth canal and the head. This will hinder the flow of oxygen. The fetus will develop hypoxia.

Fourthly, during childbirth, the handles may be thrown back. This is also fraught with various injuries.

Is it possible to correct the breech presentation of the fetus?

Many young mothers start to panic too early when they find out that their baby is in the wrong position in the tummy. For example, some women find out on ultrasound about the breech presentation of the fetus at 20, 21 or 22 weeks and are already beginning to look for ways to correct its posture. However, it is still too early to think about it. In most pregnant women, the baby is in the correct position by 32 weeks or even later.

If at 32 weeks the ultrasound showed that the fetus did not turn over and remained in the head up position, then you can begin to perform special exercises. They are effective, and in most cases, thanks to them, the breech presentation of the baby is replaced by the head presentation.

Exercises can be started with breech presentation of the fetus from 33 weeks. You should first consult with your doctor. During pregnancy with complications, you may have to give up exercise altogether so as not to harm the baby. Only the doctor will tell you whether physical exercises can be performed, and whether they will negatively affect the condition of the expectant mother and fetus.

It is recommended to start all classes with a warm-up. For several minutes, a pregnant woman can walk with a normal step, and then - on her toes and heels. Hand movements (rotation, raising and lowering), raising the knees to the side of the abdomen will not be superfluous. Below are some examples of simple exercises that can be done after 32 weeks with a breech presentation.

Exercise 1

Stand with your back straight and legs apart. The arms should hang freely along the torso. Then you should stand on tiptoes and spread your arms to the sides, bend your back, take a breath. After that, exhale and take the starting position. Do the exercise 4 - 5 times.

Exercise 2

You will need pillows to complete it. They are necessary in order to raise the pelvis. The pregnant woman should lie on the floor and put on some pillows. As a result, the pelvis should rise above shoulder level by 30-40 cm. The pelvis, knees and shoulders should form a straight line. This exercise is recommended to be performed a couple of times a day for 5-10 minutes, but not on a full stomach.

Exercise # 3

Get on all fours with your head tilted down. While inhaling, round your back. Then return to starting position. Exhale, bending in the lumbar region and lifting your head up.

Exercise 4

It is necessary to lie on your back, spreading your legs shoulder-width apart and bending them. The feet should rest on the floor. Hands should be relaxed and extended along the body. When you inhale, you should raise your back and pelvis, resting on your shoulders and feet, and when you exhale, take the starting position. Then you need to straighten your legs, take a breath, drawing in your stomach. The muscles of the perineum and buttocks should be tense. When you exhale, take the starting position again. This exercise is recommended to be repeated 6-7 times.

If you want to start doing physical exercises early (for example, at 30 weeks with a breech presentation of the fetus), then you should definitely consult your doctor.

Exercise is not the only thing that can affect the position of the fetus. Proper nutrition, walks in the fresh air are of great importance.

It is advisable for pregnant women to sit on chairs with a firm and straight back and a hard seat. Sitting on upholstered furniture, it is recommended to slightly spread your legs so that your stomach lies freely. If possible, then it is worth buying a fitball and performing special exercises on it that can affect the position of the child in the mother's tummy.

Thus, do not panic after learning from the doctor about the breech presentation of the fetus earlier than 27 weeks. The baby can change his position several times before giving birth. If desired, from 30-32 weeks in the absence of contraindications, you can begin to perform special physical exercises.

If they do not affect the position of the fetus, then the doctor will select the optimal delivery option (cesarean section or natural childbirth), which will not harm either the woman or her child.

Replies

It is considered normal if at the time of delivery the baby is in the uterus with its head down. But there are situations when legs or buttocks are below. This condition is called breech presentation of the fetus and it is always diagnosed no earlier than 28 weeks of pregnancy.

This may be due to the pathology of the uterus, low location of the placenta, or excess amniotic fluid. Often, this position of the baby becomes the cause of childbirth by cesarean section. But there are ways to correct the situation and turn the fetus over. When and how can this be done?

Types of breech presentation

There are several different types of pelvic arrangement of the baby in the womb:

Foot. This presentation occurs in 10-30% of expectant mothers, mainly during the second or subsequent pregnancy. In this case, the hips (1 or 2 at once) are extended, and the lower limb is located near the exit from the uterus;
Buttock. It usually occurs in primiparous women. In this case, the fetus is in a position with knees pressed to the stomach and hip joints bent, and its buttocks are located near the exit from the uterus;
Mixed. In this case, the hips and knees of the fetus are bent.

Causes

Breech presentation of the fetus at 20 weeks is considered normal. At this time, there is still enough space in the uterus and the baby can actively move in it, constantly turning over and changing its position.

Over time, physical activity decreases and by about 32-36 weeks, the fetus takes the final position in which it will be until the moment of birth - usually, head down.

But there are situations that prevent him from doing this. These include:

Too much or, conversely, insufficient amount of amniotic fluid in the uterus;
The presence of fibroids in the uterus, impaired uterine tone and other organ pathologies;
Low location of the placenta or its other pathologies;
Disorders in the development of the fetus (hydrocephalus, anencephaly, etc.) About how the baby should develop normally, read the article Development of the baby in the womb >>>;
The development of multiple pregnancies;
Carrying out a cesarean section during a previous pregnancy (read the related article: Natural childbirth after a cesarean section >>>).

Signs of a breech presentation

Only a doctor is able to identify the wrong location of the fetus in the uterus.

Know! Doctors note that if the baby's head is at the top, then you can notice a higher location of the uterine fundus, which does not correspond to the date. In this case, the fetal heartbeat is better heard near the navel.

During a vaginal, manual examination, the gynecologist can feel the feet, tailbone, sacrum, buttocks, or groin fold. But, the final diagnosis of breech presentation of the fetus at 32 weeks or later is made only during an ultrasound scan.

Delivery

Only a doctor can decide how the birth will take place with a breech presentation of the fetus. Moreover, it will be based on the following factors:

gestational age;
the age of the expectant mother;
the presence of diseases;
the nature of the course of pregnancy;
the size of the pelvis of the pregnant woman;
the estimated weight of the fetus, its sex and the degree of head extension;
type of presentation.

A woman can give birth on her own if she has a normal pelvic structure, a gestational age of at least 37 weeks, the estimated weight of the child is not more than 3500 g, breech presentation or mixed presentation.

It happens that they are allowed to give birth on their own only if it is known that a girl will be born. Boys in breech presentation are reluctant to accept. BUT! This is not a reason to immediately agree to an operation. Tune in to childbirth on your own, do coup exercises, work on your emotional state.

In my practice of working with pregnant women, there are cases when the child even at 38 weeks turned into a cephalic presentation. Mom worked on the Internet course Five Steps to Successful Childbirth >>>.

I did an exercise for psychological relaxation, relieved anxiety and fear of the upcoming birth. She ceased to rush from side to side, began to plunge into the correct state of the woman in labor. You can order and start studying the course by following the link. You will find a detailed description of the course program and information on how to purchase the material.

The operation is performed without fail if childbirth began early, the estimated weight of the baby is less than 2.5 kg or more than 3.5 kg, a leg presentation and hyperextension of the head are revealed.

There are situations that during childbirth, when a woman gives birth on her own, the doctor can urgently decide on delivery by performing an operation. Indications for this are as follows:

weak labor activity or its complete absence;
absence (slow or insufficient) dilatation of the cervix with progressive contractions;
identification of signs of fetal hypoxia, read in more detail about fetal hypoxia during pregnancy >>>;
prolapse of the baby's umbilical cord or limbs;
placental abruption.

Possible complications

The presence of a breech presentation has absolutely no effect on the course of pregnancy. You can only face complications during childbirth. The most common violations are:

Weak labor activity. This is due to the fact that the baby's pelvis is smaller than its head. Therefore, he exerts insufficient pressure on the uterus, which leads to weak contractions and poor dilatation of the cervix;
During childbirth, the baby's head is able to tilt back, so it will not be easy for her to get out. In this case, the likelihood of the child being injured increases;
With this position of the fetus, the umbilical cord may be clamped, due to which blood circulation in it is disturbed and, accordingly, less oxygen is supplied to the child, which is fraught with the development of hypoxia;
Passing through the birth canal, the baby can throw back the arms, which can lead to injury.

I would like to separately say that if you are well prepared for childbirth, you have a positive attitude, you clearly understand what will happen and when, then the risk of some kind of trouble tends to zero.

The simplest and most affordable solution for every mother is to start practicing the Internet course Easy childbirth >>>.

We will analyze in detail the onset of labor, what happens at each stage of the baby's birth, how you can ease contractions and how to help yourself with natural methods if the contractions are suddenly weak. Follow the link, read the program and I will be happy to help you prepare for natural childbirth.

How to flip a baby

What to do with breech presentation of the fetus? Usually, if by 34 weeks the baby is still head up? You can start doing the specific exercises recommended for breech presentation. They need to be performed regularly, alternating with each other:

The simplest of them is the flip of mommy from side to side. To do this, lie down on a hard, level surface. You can do gymnastics on the floor. Within 1 minute, you need to make 3-4 flips over the back. The time to complete the coups is about 10 minutes. This and other complexes must be performed daily, several times a day. Usually a week is enough for the fetus to take the correct position in the uterus;
Starting position: standing on all fours. Next, you need to bend your elbows and lower your head on your hands. In this case, the pelvis should be lifted up as much as possible. In this position, you need to try to fix the body;

The optimal time to be in this position is at least 5 minutes, but if you cannot stand for so long yet, then you need to do it until you feel a burning sensation in the muscles or just fatigue. But over time, try to increase the duration.

The starting position is similar to the second exercise. Standing on all fours, you need to tilt your head as low as possible. On inhalation, round your back as much as possible. On exhalation, the back should be bent at the lower back, and the head should be raised up;
Lie on the floor with your knees bent. Place pillows under the pelvis so that it rises by about 30-40 cm. It is important that the shoulders, knees and pelvis are in line. Linger for 5-10 minutes. Repeat this exercise several times a day;
Lie comfortably on your back, bend your legs and spread them a little, resting your feet well on the floor. Stretch your arms along the body and relax as much as possible. While inhaling, you need to raise the pelvis and back as high as possible, leaning at this time on your shoulders and feet. Taking a deep breath, return to the original position;

It is important that the muscles of the buttocks and perineum are as tense as possible at all times. You need to repeat this exercise 5-7 times.

Starting position: standing with a straightened back, while the legs should be shoulder-width apart. Rising on tiptoes, arms should be spread apart. As you exhale, try to bend your back strongly. Next: take the starting position on the exhale. Repeat this exercise 5 times.

Please note that recharging after meals is not recommended.

But, gymnastics with breech presentation of the fetus is not the only way to turn the baby over. It is equally important to eat right and take regular walks.

As you can see, there is absolutely nothing terrible in the breech presentation. The baby still has enough time to take the correct position in the uterus. If this has not happened by week 32, you can try to do it yourself using the exercises described above.

At the same time, it is very important to talk to your baby and ask him to help you. It seems incredible, but it works and the baby turns over correctly even before the very birth.