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Live fetus in cephalic presentation. Head presentation: the correct position of the fetus during pregnancy. Video: external obstetric coup

The location of the baby in the mother's tummy - important factor pregnancy. After all, the severity of childbirth, their course and the final result depend on the position of the fetus. If the baby is lying normally, then there should be no problems. Delivery in this case takes place naturally. If the position of the child is not what nature intended it to be, then a caesarean section is indispensable. Most likely, doctors will offer this option to a woman after an ultrasound performed on recent weeks pregnancy. On the device screen ultrasound diagnostics the tiny body of the baby, his position, position are clearly visible. The type of fetus will tell both the doctors and the woman the right decision.

Position and Presentation: What's the Difference?

Many expectant mothers often confuse terms. Therefore, before talking about the specific positions of the fetus in the womb, it is necessary to explain the meaning of these words. So, first things first. The position of the fetus is the ratio of the axes of the uterus itself and the posture of the crumbs. When determining it, doctors are guided by a conditional line that runs from the head to the pelvis of the baby. If the axes coincide, then we can talk about the longitudinal position. When they are perpendicular to each other, then the little one lies in transverse position. Medium option between the two above indicates an oblique position.

Presentation is determined by that part of the body that is in close proximity to the neck. Accordingly, it is head or pelvic. With an oblique or transverse arrangement of the crumbs, the presentation cannot be fixed. In addition, the positions of the baby are determined based on the turn of the back of the child in relation to the sides of the uterus. If it faces the left wall, they speak of its first variety. The second position is called the reverse position. Sometimes the back is turned to the front or back wall uterus. In this case, we are talking about the type of fetus. The types of fetus are called respectively: anterior and posterior. By the way, up to the baby can change its position in the womb. After this period, the situation remains stable, since in a cramped space the baby can no longer “walk around”.

head presentation

It dominates the overall statistics, as it is typical for approximately 95% of cases. Ideally, if the baby is located with the back of the head to the cervix. In this case, his chin is pressed to his chest, and his head is tilted. The first point that goes through the birth canal is a small fontanel located at the junction of the parietal and posterior bones of the skull. In this case, two types of position of the crumbs are distinguished. So, 1 position of the fetus is called anterior occipital presentation. It is characterized by the fact that the baby's face is turned back (in relation to the mother's body). The posture is observed in 90% of pregnancies. It is the most optimal for a successful delivery.

There is also a 2 position of the fetus, called the posterior occipital presentation. In this case, in relation to the body of the parent, the face is turned forward. This greatly complicates the process. During childbirth, the baby may take correct position, but this often takes a long time. The process may take a long time.

Varieties of head presentation

These are not all forms of head presentation. Among other things, it is divided into the so-called extensor types, when the head of the little one is raised to a certain extent:

  • Anterior presentation. It has a small degree of extension. The leading point becomes large fontanelle, which is located at the junction of the frontal and parietal bones. It is possible to give birth naturally in this case, but the process is much more complicated and takes longer. The thing is that the head of the fetus enters the mother's pelvis with its largest part. In fact, this position of the crumbs is an indication for a caesarean section.
  • Frontal position. Occurs in 0.5% of cases. If the size of the child is normal or large, its passage through the birth canal is impossible. Surgery is scheduled.
  • Face presentation - the maximum degree of extension of the fetal head. This situation is recorded only in 0.05% of births. The natural birth of a baby is possible, but it can be traumatic for both mother and child.

The extensor presentation of the crumbs is diagnosed by the obstetrician directly during childbirth with the help of a vaginal examination.

Head presentation and fetal positions

The anterior view of the occiput presentation at the first position of the location of the little one is the most convenient option for normal delivery. And fortunately, the most common. As already mentioned, in the first position, the baby is turned back to the left side of the uterus. In this situation, he moves "to the exit" by the most smallest diameter heads. That is, it can easily transform, stretch and narrow in order to pass through the birth canal easier and faster.

If the baby's back is turned towards right side uterus, it's already occiput presentation in the second position. The situation is not so exemplary. In this case, the chances of the so-called clinically narrow pelvis syndrome increase. A woman has strong, but unproductive contractions that slow down sharply or stop altogether. For the baby to take comfortable position- the first position, a woman needs to relax. So it will be easier for the baby to go down without colliding with the placenta if it is on the left or on top wall. The doctor will tell correct postures, which will help the baby rise in the womb, turning the head and face to the right, and the back to the left.

breech presentation

It occurs in 5% of cases. The position of the fetus in this case does not affect the birth process. Breech presentation is different:

  • The first position of the fetus is legs forward. In this case, the limbs are born first. To avoid this, the obstetrician delays the birth of the baby: he prevents his free movement with his hand. The limbs do not fall out. The peanut has the opportunity to turn its buttocks forward. If this happens, childbirth will be less dangerous.
  • The second position of the fetus in breech presentation is the buttock. It is more favorable for both the baby and his mother. Despite this, by itself breech presentation is unnatural. In this case, the doctor recommends to many expectant mothers C-section in order to protect the woman in labor and her baby from unnecessary injuries and pain.

Is a caesarean necessary?

Breech presentation is not a direct indication for surgical intervention. The positions of the fetus in this case are an additional, and not the main factor influencing the decision of the medical staff. Doctors consider the situation in a complex, taking into account other points:

  1. The age of the expectant mother, the size of her pelvis.
  2. The course of previous pregnancies of a woman, features of childbirth.
  3. Tiny size. With a breech presentation, a fetus weighing more than 3.5 kilograms is already large. With ordinary, this figure is 4,000 kg.
  4. The gender of the baby. Oddly enough, but it is very important. It turns out that breech presentation is not dangerous for girls. But in boys during childbirth, the genitals can be damaged.

What to do in this situation?

If the ultrasound showed breech presentation, before the 34th week, the woman is able to change the situation. Upon learning of the incorrect position of the fetus, she must perform some exercises:

  • It is necessary to lie on your right side and hold in this position for about 10 minutes, then quickly turn to left side. The exercise must be repeated 4 times in a row. It should be done several times a day before meals.
  • It is recommended to stand in the knee-elbow position once a day for 15 minutes.

Swimming in the pool contributes to the coup of the baby in the womb. Therefore, if you have the opportunity to buy a subscription, you need to use it. When the baby rolls over on his head, be sure to wear a bandage for several weeks to fix his position. If this does not happen, two weeks before the birth, the expectant mother is sent to the hospital. There, doctors decide how the process will go. By the way, earlier doctors tried to manually turn the baby over, massaging the pregnant belly. But then this method was abandoned due to big risk the occurrence of complications: premature birth, impaired condition of the crumbs.

Oblique or transverse arrangement

In this situation, it is impossible to determine. The position is a direct indication for a caesarean section. An oblique or transverse position of the baby in the womb occurs in 0.4% of cases. And if earlier, during childbirth, doctors tried to grab the baby by the leg and turn it over, today this method is not used. The technique turned out to be quite traumatic for both the baby and his mother. Sometimes a coup is performed during the delivery of twins. But only in the case when the first child has already been born, and the second at the same time suddenly took a transverse position.

The reasons for the oblique or transverse position of the fetus may be different. Among the main factors are tumors in the uterus, fibroids. Formations prevent the little one from lying in a natural position. Sometimes this happens when the child is very large or wrapped around his neck, it restricts his movements. One more reason - numerous births in a woman when her uterus suffered from numerous sprains. In an oblique or transverse position, a woman needs to perform all the exercises that are in this case. In this case, it is also recommended to lie more time on the side towards which the back of the crumbs is turned. The woman is hospitalized 3 weeks before the expected birth. And if the situation has not changed, it is prepared for surgical intervention.

The position of the fetus with twins

The position and type of the fetus are established during routine ultrasound diagnostics. Sometimes during such research, future parents will learn about the surprise prepared for them by nature: they will have twins! After the euphoria, they begin to wonder if natural delivery is possible in this situation. Of course, this is quite realistic, but only in two cases: if both babies occupy a head presentation or the baby that is closer to the cervix has this position, and the other is located with the buttocks forward. When the leading baby has a "pelvic position", a cesarean is recommended. The thing is that during the birth of the buttocks of the firstborn, children in the womb can catch on their heads, which is fraught with injuries. It is clear that with an oblique or transverse position, surgical intervention cannot be avoided. And even if the twins in the womb lie in the correct position, the decision on the method of delivery is made medical staff considering many factors.

Basically, all pregnant women are trying to learn more about the features of their interesting position. Therefore, quite often during the ultrasound examination, they talk a lot about the head presentation of the child.

What and how does head presentation affect

The position of the fetus is longitudinal head indicates that the head in the uterine cavity is facing the internal pharynx. This location is the most common and desirable for natural childbirth. Because in this case the head, which is the largest part of the body, will be the first to move through the birth canal. This contributes to the rapid and uncomplicated birth of a child.

Until 28-30 weeks, the position of the child very often changes. This also applies to its presenting part. But towards the end of pregnancy, the fetus is head down. In this position, most natural childbirth proceeds.

Only 3-4% are cases of breech presentation, which is a direct contraindication to natural delivery.

Occipital presentation

If the position of the fetus is longitudinal, the presenting head of the fetus may have a different placement: occipital and bending insertion of the head.

The most optimal in obstetrics and gynecology is the occipital flexion presentation. In this case, the leading point of movement along the channel is a small spring. With such a presentation in the birth process, the child's neck is bent in such a way that it is his nape that appears first. This is true for about 95% of births.

Bending insertion of the head

The remaining 5% in cephalic presentation belong to the bending insertion of the head. There are 3 degrees of such placement:

Grade 1 - the position of the fetus is longitudinal, but anterior parietal presentation, when the wire point is a large fontanel. With this placement, the possibility of self-delivery is not excluded. But there is a slightly increased chance that the baby or mother may be injured in the process. Childbirth is protracted, prevention of fetal hypoxia is required.

Grade 2 - frontal presentation, when the wire point is the child's forehead. It is he who is below all other parts of the head of the fetus. In this case natural childbirth contraindicated. In this case, only a caesarean section can complete the pregnancy (the position of the fetus (longitudinal) is abnormal).

3 extreme degree - the position of the fetus is longitudinal, but there is a presentation of the face. The head in this case will come out of the birth canal with the back of the head back. If the woman in labor has a sufficient size of the pelvis, and the size of the fetus is insignificant, independent childbirth is not excluded. Despite this, in some cases, the facial presentation of the fetus is an indication for a caesarean section.

Causes and diagnosis

The reasons for all kinds of non-standard postures and presentations of the fetus include the following:

  • narrow pelvis;
  • pathological structure of the uterus;
  • myoma;
  • placental presentation;
  • sagging of the abdominal wall;
  • heredity and others.

The position of the fetus is longitudinal head can be determined by a gynecologist after 28 weeks of pregnancy. This is facilitated by an external obstetric research. During one of them, the doctor places the open palm of his left hand over the symphysis and covers the part of the fetus that is supposed to be.

If the position of the fetus is longitudinal, the presentation is head (the photo of which can be seen above), then during palpation a dense round part is felt. She is also quite mobile and runs for amniotic fluid. The data obtained as a result of this examination can confirm or refute a vaginal gynecological examination.

When the position of the fetus is longitudinal, the presentation is head (the ultrasound photo confirms this), the heartbeat will be felt just below the woman's navel. Ultrasound procedure will help determine the position, location of the members of the body, presentation, the position of the fetus and its appearance.

How to correct presentation

If your child is in the wrong position, you can try to correct his placement. This is possible until birth process. An unstable or incomplete head presentation of the fetus in the uterus is subject to correction.

To do this, the mother must constantly change her position, more often take exactly the position that provokes the baby's movements. If the baby's head is not located directly towards the exit from the uterus, but is slightly displaced, it is necessary to lie more often on the side where the fetus is located.

Immediately after the fetal position is restored, longitudinal presentation will take place - it is necessary to fix it. To do this, you can use a bandage. You can remove it only in extreme cases, when you need to change clothes or wash.

But the fetus can change its position in the most last moment. This occurs after the outpouring of amniotic fluid. Then there is more space in the uterus, and the child has a place to make a coup.

Prevention of complications

Early hospitalization is required for those women who, after the 3rd week of pregnancy, were diagnosed with the position of the fetus longitudinal, but an abnormal variant of its presentation. This is necessary so that doctors can decide in advance on the tactics of delivery.

Most best option at wrong location baby - a caesarean section. In some cases, natural childbirth can also be performed. But they are a risky option. The presence of any additional risks is fraught not only with complications, but also with the death of the child.

Therefore it is not necessary once again to risk. In this case, this is not allowed. It is better to agree to a caesarean section and be firmly convinced that the baby will be alive and unharmed after birth. Do not be afraid of this operation, because it will help your child appear on this world completely healthy and unharmed.

Be vigilant and prudent. Good luck with your birth and healthy babies!

The position of the fetus in the womb greatly affects the course of pregnancy and childbirth.

Pregnant women are very happy when they find out that the baby is head down, which is called head presentation. But even in this seemingly favorable situation, there can be “pitfalls”, namely: different degrees extension of the fetal head.

If you start to study in detail the fetal head, you can find out that its dimensions will be very different in different planes. Thus, when passing through the birth canal, it is very important what size the head passes through the pelvic bones. In other words, nature intended that the baby's head adapts to the birth canal in a “favorable” size so that the birth goes without complications. But for a number of reasons this mechanism does not work.

In order to figure out where the line is between the norm and pathology, you need to understand the subtleties of the definitions. So, head presentation of the fetus during pregnancy is a collective concept in obstetrics.

In simple words, if the fetus is presented to the bones of the pelvis with the head, then this is called head presentation.

But this is clearly not enough for a detailed understanding of exactly how the baby's head is located. For this reason, obstetrics is given such great value seams and fontanelles on the baby's head, because it is these guidelines that help specialists determine the level of inclination and the degree of flexion of the head.

What are the types of head presentation?

  • Occipital presentation occurs in the vast majority of cases (about 90%).

This means that the baby's head is bent as much as possible, his chin tends to the chest, arms and legs are bent. This is considered a physiological position, which is called the "embryo" position. This arrangement allows the child to be born without complications.

  • The anterior head position of the fetus means that it is somewhat straightened.

In this case, the chin does not touch the chest. To the pelvic bones is no longer the back of the head (as it should be in the norm), but the parietal part.

  • With frontal presentation, the head is even more extended, which means that the presenting part is the baby's forehead.
  • Facial presentation represents the maximum degree of extension of the head. To the bones of the pelvis is the face of the fetus.

Causes of extension of the head

In rare cases, the baby can independently take the wrong position, but, as a rule, some pathological factors:

  • creates additional space for the movements of the fetus in the womb. For this reason, he can straighten his head.
  • Tumors in the fetus in the neck prevent the child from bending his head and pressing his chin to his chest.
  • , especially in the lower part of the uterus, contribute to the incorrect position of the head.
  • also interfere physiological position fetus.
  • prevent full flexion of the head.

How to determine the wrong position of the head?

The main and proven method is a vaginal examination. However, today it also allows you to reliably determine the degree of extension and serves as a confirmatory diagnostic method.

  • With occipital presentation, a small fontanelle on the fetal head is easily determined, which is located at the point of contact between the occipital and parietal bones of the skull. The ultrasound shows that the baby's head is sufficiently bent.
  • With an anterior parietal location, the small fontanel can no longer be determined, but the large fontanel, which is formed by the parietal and frontal bones, is clearly defined. According to ultrasound, it is visualized that the head is located straight and not bent.
  • The frontal position of the head differs in that it is possible to determine not only a large fontanelle, but also the superciliary arches. Ultrasound also confirms head extension.
  • Facial presentation is different in that the fontanelles cannot be palpated at all, however, you can determine the baby's face (mouth, nose, eyes). It is very important to carefully conduct a vaginal examination! Ultrasound confirms the maximum extension of the head. The angle between the chin and chest of the baby is significantly increased.

At what gestational age should the baby's head take the correct position?

Do not worry about the incorrect location of the fetus on early dates, it is still unstable due to the discrepancy between the size of the fetus and amniotic fluid. The longer the gestation period, the more distinct the following pattern becomes: and occupies most of the uterus, but.

As a rule, at 30 weeks, the final correction of the position of the fetus occurs. Later than this period, you can preliminary findings about whether the baby is positioned correctly or not.

But this is not an axiom! The position of the fetus is influenced by many factors that are individual: head size, amount of water, etc. This means that in more later dates(and sometimes even during childbirth!) the head can change its position relative to the pelvic bones.

How does the position of the head affect the birth process?

The proportions of a baby in the womb are different from those of an adult.

It is known that the head of the fetus is the largest part of its body. And this means that for happy birth child, it is necessary that she freely pass the birth canal of the mother.

Therefore, it is quite obvious that it is the position of the head, its dimensions that are the key moment in the mechanism of childbirth.

  • With occipital presentation, the head, as already mentioned, passes the birth canal the smallest sizes and is born without hindrance, without encountering difficulties.

However, it is important to remember that this is only true if the mother's pelvis is normal.

  • In the anterior parietal position, the head passes the birth canal for several big size, so even normal sizes the pelvis can become a serious obstacle.

In general, such births are possible if the head is small. But they are dangerous in that there is a high risk of hemorrhages in the brain in a child, since the head experiences strong compression on each plane of the pelvis.

Also, do not forget that damage to the birth canal of the mother can occur, and most importantly, this is not only ruptures of soft tissues, but even a divergence of the bone ring of the pelvis. More often .

  • With frontal presentation in classical obstetrics, it is believed that childbirth is impossible in a natural way, since the head passes through the birth canal with maximum dimensions.

But at deep premature fetus such genera are conditionally possible. However, with a full-term pregnancy, childbirth can end in fetal death of the child and high risk traumatism of the birth canal of a woman.

  • A face presentation baby can be born spontaneously, but extension of the head can damage it. cervical spine.

We must remember that it is there that the medulla oblongata is located, where the vital centers are located: breathing and heartbeat. Therefore, if the medulla oblongata is damaged, the child will inevitably die.

Can the position of the fetal head be changed?

Unfortunately, any attempt to change the position of the fetal head in utero is very dangerous, since there is a high risk of damage to the cervical spine, which can cause the death of the child. Therefore, the main direction of assistance with extensor positions of the head in modern obstetrics is timely diagnosis this condition and the prevention of complications.

It is for this reason that caesarean section is a very justified method of delivery in similar situations. This approach has significantly reduced both infant mortality and maternal traumatism in childbirth.

As you know, every medal has two sides. This judgment is also true in relation to the longitudinal head presentation, which can be very "insidious" in the case of extension of the baby's head. Childbirth with such a pathology is very dangerous and extremely traumatic, so it is not at all surprising that given state included in the list of indications for caesarean section performed in the interests of the fetus.

What a woman does not learn during pregnancy! And how many new medical terms accompany it interesting position! Not always clear, and sometimes disturbing. After undergoing ultrasound diagnostics, the expectant mother receives a conclusion in her hands, which deals with the presentation of the fetus. In 95-97% of cases, ultrasound ascertains the head presentation of the fetus. What does it mean and what are its types? What does cephalic presentation of the fetus mean? First of all, we note that cephalic presentation is the best option for placing your future baby in the uterus. It is characterized by the turning of the head of the child to the internal pharynx of the cervix. With this presentation of the baby, the largest part of his body - the head - moves first along the birth canal of the mother. This allows the shoulders, torso of the baby and his legs to be born without difficulty and quickly after her. You should know that before 30 weeks of pregnancy, the position of the fetus in the mother's uterus may change. But closer to the scheduled date of birth in most women (97%), the child takes a cephalic presentation. Usually after 34 weeks it is already stable and unchanged. Types of head presentation of the fetus head presentation The fetus has several types depending on the position of the baby's head. This is an anterior head, frontal, facial and occipital head presentation. Among the above types, obstetrician-gynecologists consider the occipital presentation to be the most optimal. With this variant of the presentation of the fetus during the advancement of the birth canal, the baby's neck is bent so that the back of the baby's head, facing forward, appears first. This happens in about 95% of all births. This is considered ideal option presentation and childbirth. But there are also options for extensor insertion of the head. The first degree of extension of the head is the anterior head presentation. In this case, during the expulsion of the fetus, a large fontanel on the baby's head becomes a wire point. The likelihood of injury in this situation is higher than with the occipital variant. Childbirth in this case is protracted and there is a need to prevent fetal hypoxia. The second degree of head extension is frontal presentation. It is characterized by the fact that the forehead, which is lowered below the rest of the head of the child, serves as a conducting point through the birth canal. With this variant of head presentation, childbirth in a natural way is impossible. Therefore, the woman is given a caesarean section. The third degree of head extension is facial presentation. In this version, the leading point is the child's chin. That is, the head comes out of the birth canal with the back of the head.

In this case, natural childbirth is also possible if the woman's pelvis allows it or the fetus has small size. However, facial presentation is most often considered as an indication for a caesarean section. The reasons for different fetal presentations can be the presence of a narrow pelvis in the mother, and anomalies in the structure of the uterus, and uterine fibroids, and placenta previa, and polyhydramnios. Exercises for the cephalic presentation of the fetus Specialists have developed exercises for the cephalic presentation of the fetus. They need to be performed starting from the 32nd week of pregnancy: Lie sideways on a flat sofa. Stay in this position for 10 minutes. Roll over to the other side and spend the same amount of time on the second side. This simple exercise should be done three times a day. And it is better for a pregnant woman to sleep on the side to which the head of the unborn child is tilted. Get on your knees and lean on your elbows. In such knee-elbow position you need to be 15-20 minutes. This pose is recommended to be done twice a day. Swimming. This sport perfectly stimulates the baby to turn his head down. And the suspended position of the child in the process of swimming mom has a good effect on his health. These exercises stimulate physical activity baby. He gets a better chance of taking the cephalic presentation. Important point! The above exercises cannot be performed with scars on the uterus, placenta previa and late toxicosis. Be sure to consult with your observant gynecologist before starting classes.

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, at least once, everyone 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. Yes, at the beginning labor activity the largest part of the body is the first to leave the uterus, facilitating 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 less common. 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: pathology of the uterus, scars, tumors (myoma, fibroma), narrow pelvis, weakened muscles abdominals, hypotension of the uterus, myometrial dystrophy;
  2. Fetal reasons: multiple pregnancy, premature birth, anomalies in the development of the fetus;
  3. Placental causes: polyhydramnios, oligohydramnios, too low presentation placenta, short umbilical cord, single and multiple entanglement neck.

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 an open palm right hand above the entrance to the small pelvis, in the area of ​​​​the connection 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 come to the rescue special exercises that contribute to cephalic presentation. Exercises developed by experts can be performed both independently and in ad hoc 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 effective exercises- 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 light exercise — breathing exercises in knee-elbow position. Future mom should take this position no earlier than 1-1.5 hours after eating and alternate deep breaths and exhalations, while actively arching the back. You can turn on relaxing melodies. The exercise should only be performed good mood and in 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. For physical activity there are contraindications, 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.

Stages of childbirth extensor presentation the following:

  • 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 therapeutic gymnastics. If at the time of delivery the fetus has not taken the desired position, the doctors examine the condition of the baby (is there a threat to life) and the mother, expect natural occurrence child into the world or exercise surgical intervention. 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