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What does cephalic presentation mean. Everything in its place or about head presentation

The exciting months of bearing a little one are almost behind, and the woman is preparing for the main event - a meeting with her baby.

The birth of a baby is the result of painstaking work not only of a woman, but also of a child, so he is also preparing for his birth. At short waiting times, the baby is still small, so it can move inside the uterus, freely changing its position. Therefore, they do not talk about presentation at this time. The situation changes in the third trimester, when the size of the baby imposes restrictions on freedom of movement. It is at this time that the baby turns its head down.

Head presentation of the fetus

During the examination at the appointment with a gynecologist after the 30th week, a woman often hears about the head presentation of the fetus. This wording is not always clear, and the expectant mother does not know if she should be worried when she hears it. What does the head presentation of the baby mean and is there any reason for concern in this position? Speaking about the position of the crumbs, the doctor evaluates the ratio of the axis of the uterus to the line of the child. The latter refers to the line from the back of the head to the coccyx, passing along the back. Thus, head presentation involves the longitudinal position of the baby, while his head is located on the eve of the small pelvis. This position of the crumbs is physiological and occurs in 95-97% of women. The remaining percentage includes mothers whose little ones are located with their buttocks towards the “exit” or even lie across. In this case, the delivery process will be pathological. How to determine the head presentation of the child during pregnancy?

Diagnosis of the presentation of the baby

Determining the position of the baby is an important point during the observation of a pregnant woman, as its results can affect the course of labor. Although the expectant mother should remember that information about a breech or transverse presentation received before the 34th week is not a cause for alarm, since her little one can roll over more than once. A woman can find out about the position of a peanut in several ways.

  • During a visit to the gynecologist. The doctor examines the woman by external examination and establishes the position of the crumbs. The results of the study by palpation are in most cases correct, although there are errors.
  • Ultrasound diagnostics. During such an examination, the doctor can easily find out how the little one is located in the mother's womb. The method is highly informative and more reliable compared to the previous method, and it is also completely safe for both participants in the procedure.

Many women are interested in the question, can they independently determine the head presentation of the fetus during pregnancy? This is not easy to do, but you can try using the techniques used by obstetricians-gynecologists:

  • Place your palms on your upper abdomen. The buttocks will be soft to the touch and motionless, the head will be more dense and balloting. In the longitudinal position, the head and buttocks will be determined in the left and right parts of the abdomen.
  • With your right hand, grab the lower abdomen between your fingers (forefinger and thumb). If the head is down, you will feel for it.

If the expectant mother has doubts or concerns about the baby, it is better to trust the specialists and conduct additional medical examinations.

Head presentation: positions and types

The head presentation of the crumbs can have several "variations". There are the following types of head presentation:

  • The occipital is the most natural from the position of the physiology of childbirth and therefore the optimal position. In the process of moving along the birth canal, the neck is bent, the chin is pressed to the chest, and the baby goes with the back of the head forward. In this case, the likelihood of injury to both mother and baby is minimal.
  • Anterior head (parietal) position - the head of the crumbs is tilted forward, but not as much as possible. The wire point in the process of birth is a large fontanel. With this position of the child, both natural and operative delivery is possible. Mandatory monitoring of the condition of the baby and the prevention of his hypoxia, as there is a protracted course of childbirth in the majority of cases. Natural birth is often accompanied by trauma.
  • The frontal position is an infrequent phenomenon, but quite dangerous. In this case, the neck is extended, the baby goes through the birth canal forehead forward. Delivery in a natural way with this position of the crumbs is impossible, surgery is performed - a caesarean section.
  • Facial position. This is the presentation of the head longitudinal, in which there is a strong deviation of the head back. In this case, the leading point is the chin. The baby moves backward with the back of the head. The prognosis of delivery, as well as the technique of its implementation, depend on many factors, not least of which are the size of the pelvis and baby, the activity of labor. Both natural birth and caesarean section are possible. The decision is made in each case individually.

In addition, the "position" of the baby is also important - the location of the back of the crumbs relative to the uterine walls. According to this criterion, with head presentation, positions are distinguished:

  • 1 position - the most common option, in which the back of the crumbs is facing the left uterine wall. This position is considered physiological and safe.
  • 2 position - the back of the baby is turned to the right wall of the uterus.

When the back of the crumbs is turned to the anterior or posterior wall of the uterus, they speak of an anterior or posterior head presentation, respectively.

Low cephalic presentation

For a natural and prosperous course of pregnancy and subsequent delivery, not only the location of the crumbs relative to the axis of the uterus is important, but also how close the child is to the “exit”. With the approach of the moment of the birth of the baby (approximately at the 38th week), it descends. But the fact that the presentation is head, and the baby is low, a woman can also find out in the period from the 20th to the 36th week. In this case, there may be a threat of premature delivery. If the doctor said that the baby is low, do not immediately panic. Compliance with all recommendations will help to bring the pregnancy to the due date.

  • The best helper for a woman is a prenatal bandage, which will relieve the load and “support” the expectant mother.
  • Avoid physical activity.
  • Don't run.
  • Try to get more rest.

The course of childbirth in most cases is normal and has a successful outcome - the appearance of a new person.

Causes of incorrect presentation

Unfortunately, the baby is not always located the way nature "intended" it. The reasons can be very diverse:

  • The woman has an anatomically narrow pelvis.
  • There are anomalies in the structure of the uterus.
  • Polyhydramnios - as a result, the activity of the child can be increased.
  • Low water - the mobility of the crumbs decreases.
  • Myoma of the uterus.
  • Reduced uterine tone, as a result of which the ability of the organ to contract is reduced.
  • Placenta previa.
  • External factors - incorrect position of the body during sleep, clothing that brings discomfort.
  • Heredity.

In the presence of the above factors, the likelihood that the child will not be located in the head presentation increases significantly.

Exercises to correct the position of the baby

If the pregnancy has “stepped over” the 34th week, and the baby’s head is not in the lower part of the uterus, the doctor may recommend helping the baby to take a physiological position. If the baby is large, the doctor will pay attention to this factor after the 30th week. How to turn the baby into head presentation? A number of exercises will help the crumbs to position themselves correctly:

  • A woman needs to lie on her side on any hard surface - the floor, the couch, the sofa. Spend 10 minutes in this position. Roll over to the other side and wait another 10 minutes. Repeat the exercise 3-4 times. During the day, it is desirable to make 2-3 approaches.
  • Take a knee-elbow position and stand in this position for 15-20 minutes. Repeat 2-3 times a day.
  • Swimming is a great way to keep a woman in shape. In addition, classes have another "bonus" - this sport is able to stimulate the turn of the little one with his head down.
  • Lie on your back, after placing a pillow under the buttocks, and raise your legs (the limbs are bent at the knees). The pelvis should be 30-40 cm above shoulder level. Buttocks, knees and shoulders form a straight line. Very often, after one approach, the baby takes the correct position. If not, the exercise is performed 1-2 times a day.
  • Lie on your side, bend your knees and pull them slightly towards the body. Wait 5 minutes, take a smooth deep breath and roll over to the other side for another 5 minutes through your back. If the baby is located with his buttocks towards the “exit”, the starting position is the side towards which the back of the little one is facing. If the position is transverse, you should start from the side towards which the head is facing. Further straightens the upper leg (with breech presentation) and the lower (with an oblique position). Lie down. Bend your leg again. Grab your knee (upper) with your hands and describe a semicircle inward with it, touching the wall of the abdomen. Release your leg and relax. Repeat the exercise 5-6 times.

It is worth remembering that all exercises are performed at a calm pace and only after consultation and approval from the doctor.

Other types of presentation

If, despite all efforts, the pelvic presentation of the child is preserved, and not the head presentation of the child, or there is a transverse arrangement, the doctor decides on the delivery technique:

  • Breech (pelvic) presentation. In this case, both natural childbirth and caesarean section are possible. Among the determining factors are the size of the pelvis of the woman in labor and the weight of the baby. More often than not, surgery is preferred.
  • Transverse (oblique) arrangement. In this position, the baby is delivered by surgical intervention. Natural births are excluded.

If it is not entirely clear to the expectant mother how, according to the idea of ​​\u200b\u200bnature, the baby should be located, the doctor can show the woman options for head presentation in the photo. Thus, the pregnant woman will have a clearer and more accurate understanding of the physiology of the birth process, many worries and doubts will go away.

Even in the case of head presentation, there are cases when natural birth is impossible or poses a danger to the mother and baby. Do not despair if your baby turned around in a way that would be better in terms of physiology. The doctor may decide on an operative intervention - a caesarean section. The operation will allow your baby to be born healthy, and this is the most important thing for every mother!

If a woman already has a child, then she has already received answers to many questions regarding pregnancy and childbirth. But for expectant mothers who are waiting for the birth of their first baby, this path has yet to be passed. At different periods of fetal development, questions arise that are specific to this particular time. So, starting from the 32nd week of pregnancy, according to the results of a photo ultrasound examination, the doctor can diagnose a breech or head presentation of the fetus. For proper gestation and upcoming childbirth, this information is labeled "especially important."

What the statistics say

If we take the total number of women in labor as 100%, then only 3-5% falls on the so-called breech presentation. Childbirth in this case is considered pathological and often occurs by caesarean section.

Head presentation of the fetus is the desired and most common position for natural childbirth, when the baby's head is located at the entrance to the small pelvis. There are several varieties of this option:

  • frontal;
  • facial;
  • occipital;
  • anterior head.

Presentation and its variants are determined using a photo of an ultrasound examination, and depending on this, the gynecologist determines the tactics of childbirth. The most ideal is the occipital presentation of the fetus. In this position, the baby moves through the birth canal with a slightly bent neck and is born with the back of the head forward. Such childbirth, as a rule, takes place without breaks for the mother and without injuries for the baby.

The head presentation of the fetus according to the facial type is characterized by the maximum tilting of the baby's head. In this position, it turns out that it comes out of the birth canal with the back of the head. In this situation, focusing on palpation and the results of an ultrasound examination, the doctor may recommend a caesarean section. The option of natural delivery is also possible under certain conditions:

  • the woman in labor has a wide or regular size pelvis;
  • the fruit is not large, up to 3,200 g;
  • active course of the birth process;
  • the baby's chin is directed in accordance with the anterior variety of facial presentation.

Head frontal presentation is a 100% indication for childbirth by caesarean section. Such an arrangement of the fetus during childbirth is very rare, about 1-2% of the total.

Anterior head, or as it is also called anterior parietal, the presentation variant is characterized by such a position during childbirth, when the baby is forced to move forward with the fontanel. In this case, the mother can give birth on her own, but there is a possibility of hypoxia and trauma to the fetus.

In addition to the head arrangement of the four types, it is also taken into account to which wall of the uterus, left or right, the baby is turned back. The left, most common option, doctors call the 1st position of head presentation. If the baby is turned back to the right side of the uterus, then we are talking about the 2nd position.

That's what nature intended

The incorrect position of the fetus at the time of the onset of childbirth is caused by several reasons. This may depend on the anatomical structure of the uterus or be explained by hereditary factors. The position of the baby directly depends on the location of the placenta and polyhydramnios during pregnancy.

Head low presentation is also considered a deviation from the norm if it is diagnosed starting from the 22nd week of pregnancy. In the normal course of pregnancy, the downward movement of the fetus begins at the 38th week. At earlier periods, this may threaten premature birth or the threat of miscarriage, so the further course of pregnancy occurs under the supervision of a doctor and often in a hospital.

When diagnosing "low cephalic presentation" at home, you must adhere to a few simple, but mandatory rules:

  • exclude all types of outdoor activities and physical activity. This is especially true for lifting weights.
  • use a bandage;
  • do not take hot baths;
  • lie more and be less nervous.

Terms and methods for diagnosing the position of the baby

You can talk about the head or pelvic position of the fetus, starting from the 28th week of pregnancy. At this time, the baby's head is already palpable during an external examination during palpation. But for a more accurate determination of the position of the fetus, an ultrasound examination is performed, when on the monitor or in the photo you can see in more detail. But for about a month, the baby can change position. But starting from the 32nd week, head or breech presentation can be diagnosed with a high degree of probability.

While the fetus is still very small, it can move quite freely in the uterus in different directions. The closer the due date, the less free space remains for the child. At a short gestational age, the doctor can diagnose the patient with an "unstable position" - this means that the fetus is still actively moving. In the early stages, this is considered the norm. The child usually occupies the final position by the 33-34th week of pregnancy (and in the second and subsequent pregnancies, even on the 38th).

Presentation indicates how the baby is located in the uterus - upside down or legs. In addition to presentation, there is also the term "fetal position". In obstetrics, the correct position of the child is determined by the ratio of its axis to the axis of the uterus. The axis of the fetus conditionally runs along the spine, connecting its coccyx and the back of the head. The axis of the uterus divides it into equal halves. Relative to the axis, the child can be located in a longitudinal position, oblique or transverse.

The most dangerous is the transverse position. Natural childbirth in this case is prohibited, since this position of the fetus is dangerous with severe injuries to the newborn. In an oblique position, in order to avoid risks, as a rule, a cesarean is also prescribed. However, often the child changes position from oblique to normal longitudinal already during childbirth.

Question 2. What is the presentation of the fetus?

In addition to being located along or across the axis of the uterus, the fetus can lie upside down or upside down. In this regard, there are two main types of presentation:

  • head (head down);
  • pelvic (upside down or buttocks).

The position of the baby upside down is considered the norm, which happens in most cases. Depending on which part of the head is located at the entrance to the small pelvis, it is also divided into occipital, parietal, frontal and facial. With the occipital, the baby's head is bent, and therefore this position is called flexion, and the rest - extensor.

Flexion cephalic presentation is the most optimal and natural position of the child, in which childbirth can proceed naturally without hindrance, since the head, the most voluminous part of the body, will go through the birth canal first. This will allow the rest of the pieces to come out faster and easier.

Breech presentation is much less common. There are three options for breech presentation:

  • foot (legs of the child are located in front);
  • gluteal (the buttocks of the child are located in front);
  • mixed (legs and buttocks of the child are located in front).

Foot presentation can be complete (the fetus is located with both feet down), incomplete (one leg) or knee (he sits on his knees, as it were). More favorable is the breech presentation.

Question 3. What is a low presentation?

In addition to the listed forms of presentation, there is also the so-called low presentation. It refers to the too early lowering of the child's head into the pelvic region of the woman. This usually happens 3-4 weeks before delivery, but it can happen earlier. A deviation from the norm is the lowering of the head before the 22nd week of pregnancy. The result of such a presentation may be premature delivery.

If you have been diagnosed with such a diagnosis, it is important to take care of yourself, limit physical activity, including outdoor activities, and all kinds of stress, lie more, and also use a support bandage. A low presentation can also cause the expectant mother to be hospitalized in a hospital under observation.

Question 4. What are the causes of incorrect presentation?

It is very difficult, sometimes even impossible, to determine the specific cause of a particular position of the fetus in the uterus. Doctors identify a number of reasons due to which the presentation may become incorrect:

  • high fetal activity;
  • oligohydramnios or polyhydramnios;
  • overstretching (hypotonicity) of the walls of the uterus - due to repeated pregnancy or multiple pregnancy;
  • uterine scars;
  • very narrow pelvis of a pregnant woman;
  • anomalies of the uterus (saddle uterus, bicornuate, etc.);
  • tumors, uterine fibroids;
  • short umbilical cord;
  • entwining the child with the umbilical cord;
  • small fruit weight.

Question 5. Why is incorrect presentation dangerous?

Presentation is a very important indicator for a doctor. The method of delivery that will be prescribed in order to avoid complications depends on this. Incorrect presentation is dangerous for birth injuries and other problems for both a woman (ruptures of the external genital organs, hematomas are possible) and for her child (hypoxia, asphyxia, hematomas may occur), up to the death of the fetus in the most severe cases.

In addition, the birth itself can be more difficult, weakness of labor activity is possible.

Question 6. How to determine the type of presentation?

It is impossible to independently determine the location of the child in the uterus. This can only be done by a doctor.

As a rule, the definition of presentation is included in the planned examinations of a pregnant woman from about the 28th week (when the position of the baby can still be changed). It is carried out using the following methods:

  • external determination of the location of the fetus by an obstetrician using palpation (palpation) through the wall of the abdomen;
  • vaginal examination;

Question 7. How is childbirth with the wrong presentation?

It is very important to determine the position of the child: it is one of the main indicators for choosing the method of delivery. So, the most favorable for natural childbirth is the head occipital (flexion) presentation.

However, head presentation is not always an indicator for natural delivery. Such a presentation can become dangerous if it is extensor (frontal, parietal or facial). Often this position is established immediately before childbirth, and then an emergency caesarean section can be performed to avoid possible injuries to the woman and child. In some situations, a caesarean section is mandatory. So, with frontal and facial presentation, there is a big risk of injuring the baby's neck, since it is very strongly curved. The most dangerous is the facial presentation. In this position, the neck is in a very unfavorable condition and can be injured.

Breech presentation is even more difficult and carries with it the risk of complications for both the fetus and the mother. The complexity of this situation lies in the fact that the first part of the child's body is born less voluminous, and further births are more difficult.

However, breech presentation does not always mean that you will have to do a caesarean section. For example, in the gluteal position, a woman can try to give birth herself. The choice in this case is always individual. It all depends on a number of reasons: the size of the fetus (with a breech presentation, a child over 3.5 kg is considered large, and with a head presentation - more than 4 kg), the size of the mother's pelvis, the sex of the baby (for boys, natural birth in breech presentation is dangerous with genital injuries) and currents of previous births.

In addition, natural childbirth with a breech presentation often leads to ruptures and damage to the mother's genitals. Therefore, it is better to immediately reduce such risks to a minimum.

Question 8. What can be the presentation of twins?

With multiple pregnancies, babies can be in the mother's stomach in a different position, and it depends on how much easier or more difficult the birth will be.

Several scenarios are possible:

  • cephalic presentation of both children. In this case, often, in the absence of other indications, natural childbirth is allowed;
  • the child, which is closer to the exit from the uterus, is located in the head presentation, and the second - in the pelvic. In this situation, childbirth can also take place naturally without problems;
  • the first baby is in the pelvic position, the second - in the head. During childbirth, they can catch on their heads, so perhaps the doctor will prescribe delivery by caesarean section;
  • if one of the children is in a transverse presentation, as a rule, a caesarean section is prescribed.

Question 9. Is it possible to make the fetus turn to its normal position?

The baby can roll over in the mother's stomach for a long time, therefore, if the gynecologist diagnosed an incorrect presentation, the baby can be tried to be forced to turn on its own. This is facilitated, for example, swimming in the pool. You can also do the following exercises at home:

  • twice a day for 10-15 minutes to become in the knee-elbow position;
  • roll over yourself: lie on one side, lie down for about 10 minutes, and then quickly turn around on the other side, and repeat 4 times.

Such exercises should not be practiced if there is a threat of premature birth, if there are scars on the uterus, placenta previa, preeclampsia, and any complications of pregnancy.

If studies have shown that the fetus has turned over, a special bandage can be worn to fix its position. It is important to remember that only a doctor can prescribe a bandage, you cannot choose and wear it yourself.

Question 10. Can the doctor turn the fetus over himself?

In the past, doctors tried to turn the child over with their hands, but today they have stopped doing this due to low efficiency, and most importantly, complications. Manual rotation is dangerous for violations of the condition of the fetus, as well as premature detachment of the placenta, and hence premature birth.

If your doctor has diagnosed you with a presentation other than head presentation, do not panic. Firstly, the child can change his position for a long time. But most importantly, the risks of complications are minimized if the presentation is diagnosed on time, so do not forget to visit the gynecologist regularly during pregnancy and undergo all the necessary examinations. In this case, you should not be afraid of a cesarean section either: this is the only way you will get a guarantee that the birth will take place without injuries, and you, and most importantly, your baby will remain healthy.

This position is divided into four types according to the zone closest to the exit:

  • Occipital presentation. This is the ideal scenario. From it, the child moves along the birth canal with the back of the head forward with the least likelihood of birth injuries. In addition, this is the least likely to rupture the vagina and perineum in the mother.
  • Facial. The fetal head is thrown back, and the face is closest to the exit. It moves forward along the birth canal, which is dangerous with injuries to the face and neck.
  • Execution. This is the rarest case of cephalic presentation, occurring in 1-2%. The head is directed with the forehead towards the exit to the mother's pelvis.
  • Anterior head. The direction of the head is the top of the head towards the exit. Movement to the exit fontanel forward.

When classifying head presentation, the position of the fetus relative to the walls of the uterus and its own axis is also taken into account - close to the right or left wall, turned back or sideways. Thus, positions are distinguished:

  • the first - the back is closest to the left wall of the uterus;
  • the second - the back is closer to the right wall of the organ.

Low cephalic presentation

Determined at 20-38 weeks. This condition is dangerous by premature delivery, so a woman with this diagnosis is taken under increased supervision. In this case, the doctor recommends that pregnant women exclude any possibility of negative effects on the uterus and baby:

  • reduce physical activity;
  • rest lying down more often;
  • not to run;
  • do not lift anything heavy.

Head presentation with low placentation

Low placentation is a dangerous complication of pregnancy with any fetal presentation, including head presentation. The peculiarity of this pathology is in the location of the placenta in the lowest zone of the uterus, closest to the exit. Only then, a little higher is the head of the fetus. The placenta covers the internal os of the uterus, which causes premature birth. An underdeveloped fetus dies as a result of hypoxia due to insufficiency of placental circulation. The probability of death is 7-25%. Bleeding with placental presentation can cause maternal death in 1-3% of cases. In some cases, the placenta changes position. Then childbirth takes place on time without complications.

Diagnosis of head presentation of the fetus

Head presentation of the fetus is finally diagnosed during pregnancy at 30 weeks. The position of the fetus is also determined at 22 weeks, but before delivery it may change - the embryo changes position until 32 weeks. Palpation and ultrasound methods are used for diagnosis.

A woman can conduct a preliminary diagnosis herself. To do this, lie on your back with bent legs, put your hand on the lower abdomen. With the correct position, the child's head will be slightly palpable. In this case, it is impossible to establish the type of presentation on its own, as with palpation. An ultrasound is required.

Planned ultrasound allows you to assess the position of the embryo comprehensively. By changing the position of the sensor of the device, the doctor receives a detailed picture of the fetus. The position in relation to the walls of the uterus and its pharynx is assessed, a preliminary diagnosis is made. From this point on, the obstetrician-gynecologist checks the position of the fetus at each examination. At the slightest change, a referral for an additional ultrasound is possible.

Childbirth with cephalic presentation of the fetus

If the embryo is facing the exit, many doctors recommend a caesarean section, especially if the baby is large. Natural delivery is possible only with a wide pelvis of the mother and the weight of the embryo up to 3200 gr. Both the activity of labor and the direction of the chin are taken into account.

Frontal presentation is a direct indication for a caesarean section. The risk of severe injury to the fetus and damage to the mother is very high. The same applies to the front head presentation. Due to the fact that the child moves forward along the birth canal with the fontanelle forward, there is a high probability of hypoxia and injuries.

Low presentation is an indication for normal natural childbirth. Childbirth does not differ in complications, it is easy.

How to achieve head presentation of the fetus

The location of the embryo in the womb can be corrected. For this, a pregnant woman needs to observe rest and do gymnastics. which the doctor recommends. If these measures do not work, the woman is hospitalized in advance and an external coup of the fetus is prescribed in the head presentation. This is a procedure during which the doctor directs the head of the embryo down by turning the whole body. This manipulation is possible under the following conditions:

  • transverse presentation (with pelvic not done);
  • the abdominal wall is pliable;
  • the pelvis is of normal size;
  • mother and fetus in a satisfactory physical condition.

Before the procedure, the woman's bladder is emptied. To relieve the tone of the uterus and pain syndrome, an injection of a solution of promedol is given. The patient is placed on the couch on her back with her legs bent at the knees. The doctor is located to the right of the woman and puts one hand on the place where the fetal head is located. Then he gently shifts it towards the cervix, while moving the pelvic end to the bottom of the organ. After the procedure, to fix the head longitudinal presentation of the fetus, two rollers are applied to the woman's stomach, and the stomach is bandaged from above. With this device, the patient stays in the hospital until delivery.

For many women who have not given birth, the phrase "cephalic presentation of the fetus" leads to a dead end. However, even in films and TV shows, everyone at least once heard how the heroine is reassured during childbirth with the words "the head has already appeared!" It is not difficult to guess that the head presentation of the fetus is very good.

Head presentation of the fetus: its types and differences from other types of presentation

Head presentation of the fetus - the location of the child in the womb in such a way that the head is closest to the birth canal. So, at the beginning of labor, the largest part of the body first leaves the uterus, facilitating the further movement of the fetus.

During pregnancy, the presentation of the fetus may change, and by 32-35 weeks it is finally fixed. As a rule, cephalic presentation is diagnosed in 90% of cases. In addition to the head, there is a pelvic and transverse (oblique) presentation.

Breech presentation occurs only in 3-5% of cases. Here, the legs or buttocks of the fetus are closest to the neck. These parts of the body are smaller than the head, so there may be difficulties during childbirth when the whole body of the baby has already appeared. With a breech presentation, in some cases, a decision is made on a caesarean section.

Transverse or oblique presentation are even rarer. This feature is a mandatory indication for caesarean section, because. no part of the body is present, and an artificial reversal can be dangerous for both the woman in labor and the fetus.

As for head presentation, despite its frequency and favorableness, there are also some risks, because there are several forms:

  • Occipital;
  • Anterior head;
  • frontal;
  • Facial.

Occipital circulation is the most optimal: the chin is pressed to the chest, and during childbirth, the back of the head comes forward. In this case, the face can be directed forward or backward (90% of cases).

Frontal and facial presentation are almost always indications for a caesarean section, anterior parietal (anterior head) requires an individual decision. When referring to the cervix of the face, the narrow part of the head or the lower body, in most cases there are great risks for both the baby and the mother, childbirth lasts longer and is accompanied by complications, so the question of a caesarean section is taken in advance.

Whether the operation will be performed depends on the size and weight of the fetus and the size of the maternal pelvis, on the age and health of the woman in labor, on the outcomes of previous births and other features. In some cases, on the contrary, a caesarean section is contraindicated, and doctors do everything so that a woman can give birth naturally without serious losses.

Causes of incorrect presentation

Approximately 90-97% of children take the correct presentation a few weeks before birth, but some of them are turned to the neck incorrectly.

The most dangerous is the breech presentation and its types - gluteal, foot, mixed. Some forms of head presentation (frontal, frontal, facial) are also considered incorrect. Why it happens?

Conventionally, there are three groups of causes of incorrect presentation:

  1. maternal reasons: uterine pathology, scarring, tumors (myoma, fibroma), narrow pelvis, weakened abdominal muscles, uterine hypotension, myometrial dystrophy;
  2. Fetal reasons: multiple pregnancy, premature birth, fetal abnormalities;
  3. Placental causes: polyhydramnios, oligohydramnios, too low placenta previa, short umbilical cord, single and multiple neck entanglement.

Also, presentation may be incorrect again if the same feature was found in previous births.

Diagnosis of head presentation

Until the 28th week, you should not worry about the incorrect presentation of the fetus: usually closer to the birth, the child "gets up" in the right direction. Starting from this period, the obstetrician-gynecologist diagnoses presentation using

external methods of obstetric research. To do this, the doctor places the open palm of the right hand over the entrance to the small pelvis, in the area of ​​\u200b\u200bthe junction of the pelvic bones. With head presentation, the specialist will find a rounded dense part that shows mobility in the amniotic fluid - this is the head.

Exercises to correct the position of the baby

Many expectant mothers are worried if the baby is not in a hurry to take the right position in the womb. Then special exercises come to the rescue, which contribute to the head presentation. Exercises developed by specialists can be performed both independently and in special groups. In therapeutic gymnastics, it is important to perform each action consciously and very smoothly, slowly, without overloading the body. If the expectant mother feels unwell, the exercises should be stopped.

One of the simplest and most effective exercises is alternate lying on different sides. A pregnant woman is recommended to lie down on her right side before eating, lie down for about 10 minutes, then on her left side and repeat the same. In one approach, you can turn around 3-4 times. During the day, you can perform this exercise up to 3 times and always do it before meals.

Another useful and easy exercise is breathing exercises in the knee-elbow pose. The expectant mother should take this position no earlier than 1-1.5 hours after eating and alternate deep breaths and exhalations, while actively arching her back. You can turn on relaxing melodies. Exercise should be performed only in a good mood and with normal health. Also, the knee-elbow position has its own contraindications: it is preeclampsia and the threat of abortion.

A pregnant woman should lie on a sofa or couch in such a way that her legs are 20-30 cm higher than her head, and her pelvis is raised. To do this, pillows or rollers are placed under the lower back and legs. After that, you need to lie down for 10-15 minutes, relaxing, and then proceed to your business.

Therapeutic exercises must be performed on an empty stomach and, of course, agreed with the doctor. There are contraindications for physical activity, even if it is just lying on your side, so it is important to get the permission of your doctor.

Features of childbirth with facial, frontal and anterocephalic types of presentation

Facial, frontal and frontal presentations are called in one word - extensor. If, starting from the 29th week of pregnancy, the diagnosis shows an extensor presentation of the fetus, they speak of pathological childbirth.

For anterior presentation, the first degree of extension is characteristic: a large fontanel acts as a wire point. For the frontal, in which the wire point is the forehead, the second degree is characteristic. The third degree of extension is observed with facial presentation, and the chin acts as a wire point.

The stages of childbirth with extensor presentation are as follows:

  • extension of the head;
  • Internal rotation of the head;
  • Flexion of the head after the formation of a fixation point at the lower edge of the pelvic bones. The end of the stage is the appearance of the head outside the womb;
  • With anterior head and frontal presentation, the back of the head is fixed at the top of the coccyx, and the head is unbent. With the front - the internal rotation of the shoulders and the turn of the head;
  • The birth of a child.

As a result of childbirth with extensor presentation, the shape of the child's head may be modified: elongated towards the crown, forehead or chin, high straight standing of the head, low transverse standing of the head, tilt of the skull to the shoulder, and others.

Natural childbirth with all three types of presentation is possible only if the fetus is small and the mother's pelvis is wide, the pregnancy was easy and there are no problems with the mother's health and a threat to the baby (hypoxia, umbilical cord wrapping, spasm). When the chin is turned back with a facial presentation, in all cases a caesarean section is done, forward - only natural childbirth is allowed.

In any case, if an abnormal presentation of the fetus is detected, doctors begin to closely monitor the condition of the woman in labor and the fetus from the 28th week, conduct numerous studies (palpation, ultrasound) in order to decide on the method of delivery with the least risks. Fortunately, malpresentation of the fetus is extremely rare, and in most cases is corrected with the help of therapeutic exercises. If at the time of delivery the fetus has not taken the desired position, doctors examine the condition of the baby (is there a threat to life) and the mother, expect the child to be born naturally or perform surgery. Turning the baby manually is done only with exceptions, when both natural birth and caesarean section can harm mother and child.

Especially for- Elena Kichak