The location of the baby in her mother’s tummy is an important factor in pregnancy. After all, the severity of childbirth, their course and the final result depends on the position of the fetus. If the crumb is normal, then problems should not arise. Delivery in this case takes place naturally. If the child’s position is not what nature intended, then a cesarean section is indispensable. Most likely, doctors will offer this option to a woman after an ultrasound scan performed in the last weeks of pregnancy. On the screen of the ultrasound diagnostic apparatus, the tiny body of the baby is clearly visible, its position, position. The appearance of the fetus will tell both doctors and the woman the right decision.
Position and presentation: what is the difference?
Many future mothers often confuse the terms. Therefore, before talking about the specific position 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 pose of the baby. When determining it, doctors are guided by a conditional line that runs from the baby’s head to the pelvis. If the axes coincide, then we can talk about a longitudinal position. When they are perpendicular to each other, the little one lies in the transverse position. The middle 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 the head or pelvic. With an oblique or transverse arrangement of the crumbs, the presentation cannot be fixed. In addition, the position of the baby is determined based on the reversal of the back of the child in relation to the sides of the uterus. If it is facing the left wall, they speak of its first variety. The second position is called the reverse position. Sometimes the back is facing the front or back of the uterus. In this case, we are already talking about the form of the fetus. The types of the fetus are called, respectively: front and rear. By the way, up to the 34th week of pregnancy, the baby can change its position in the womb. After this period, the situation remains stable, since in the cramped space the baby can no longer “walk off”.
Head presentation
It dominates the overall statistics, as it is typical for approximately 95% of cases. Ideally, if the baby is located in 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 the small fontanel located at the junction of the parietal and posterior bones of the skull. In this case, two varieties of the 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 face of the baby is turned back (in relation to the mother’s body). The pose is observed in 90% of cases of pregnancy. It is the most optimal for a successful delivery.
There is also the 2nd position of the fetus, called the posterior occipital presentation. In this case, the face is turned forward in relation to the body of the parent. This greatly complicates the process. During childbirth, the baby can take the correct position, but it often takes a lot of time. The process may be delayed.
Varieties of head presentation
These are not all forms of head presentation. Among other things, it is divided into the so-called extensor species, when the head of the toddler is raised to a certain extent:
- Forehead presentation. It has a small degree of extension. The leading point is the large fontanel, 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 goes much more complicated and longer. The thing is that the fetal head enters the mother’s pelvis with its largest part. In fact, such a crumb pose is an indication for cesarean section.
- Frontal position. It occurs in 0.5% of cases. If the size of the baby is normal or large, its passage through the birth canal is impossible. Surgery is prescribed.
- Facial presentation - the maximum degree of extension of the fetal head. This situation is recorded only in 0.05% of births. The natural appearance of the baby is possible, but it can become traumatic for both the mother and the child.
The extensor presentation of the baby is diagnosed by the obstetrician directly during childbirth with the help of vaginal examination.
Head presentation and fetal position
The front view of the occipital presentation at the first position of the location of the baby is the most convenient option for normal childbirth. And fortunately, the most common. As already mentioned, in the first position, the baby is facing back to the left side of the uterus. In this situation, he moves “to the exit” with the smallest diameter of the head. That is, it can easily transform, stretch and narrow, so that it easier and faster to pass through the birth canal.
If the back of the baby is turned to the right side of the uterus, this is the occipital presentation in the second position. The situation is not so exemplary. In this case, the chances of a so-called clinically narrow pelvis syndrome increase. A woman has strong, but unproductive contractions, which sharply slow down or completely stop. For the baby to take a comfortable position - the first position, a woman needs to relax. So the crumb will be easier to go down without colliding with the placenta, if it is on the left or on the upper wall. The doctor will tell you the correct postures that will help the baby to rise in the womb, turning the head and face to the right, and the back to the left.
Pelvic presentation
It occurs in 5% of cases. The position of the fetus in this case does not affect the birth process. Pelvic presentation can be different:
- The first position of the fetus is with the legs forward. In this case, the limbs are born first. To avoid this, the obstetrician delays the appearance of crumbs in the light: he prevents his free movement with his hand. Limbs do not fall out. The little one has the opportunity to turn his buttocks forward. If this happens, childbirth will be less dangerous.
- The second position of the fetus with pelvic presentation is the gluteal. She is more favorable for both the baby and his mother. Despite this, pelvic presentation itself is unnatural. In this case, the doctor recommends to many expectant mothers a cesarean section in order to protect the woman in labor and her baby from unnecessary injuries and pain.
Is Cesarean required?
Pelvic presentation is not a direct indication for surgical intervention. The fetal position in this case is an additional, and not the main factor affecting the decision of medical personnel. Doctors consider the situation in the complex, taking into account other points:
- The age of the future mother, the size of her pelvis.
- The course of previous pregnancies of a woman, especially childbirth.
- The size of the crumbs. With a pelvic presentation, a fetus whose weight exceeds 3.5 kilograms is already large. In ordinary cases, this figure is 4,000 kg.
- Paul's baby. Oddly enough, but it is very important. It turns out that pelvic 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 scan showed a pelvic presentation, before the 34th week a woman is able to change the situation. Having learned about the wrong position of the fetus, she is obliged to perform some exercises:
- It is necessary to lie on the right side and spend about 10 minutes in this position, then quickly turn to the left side. The exercise must be repeated 4 times in a row. It should be done several times a day before eating.
- It is recommended that you stand in a knee-elbow position once a day for 15 minutes.
A baby in the womb is helped by swimming in the pool. Therefore, if you can buy a subscription, you need to use it. When the baby turns on its head, be sure to wear a bandage for several weeks to fix its position. If this does not happen, two weeks before the birth, the expectant mother is sent to the hospital. There, doctors make decisions about how the process will go. By the way, before doctors tried to manually turn the baby over, massaging the pregnant belly. But then this method was abandoned because of the great risk of complications: premature birth, placental abruption, disturbances of the baby's condition.
Oblique or transverse arrangement
In this situation, it is impossible to determine the presentation of the fetus. The position is a direct indication for cesarean section. An oblique or transverse pose 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, then today this method does not apply. The technique turned out to be rather traumatic for both the baby and his mother. Sometimes a coup is made 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 unexpectedly took a transverse position.
The reasons for the oblique or transverse position of the fetus may be different. Among the main factors - tumors in the uterus, fibroids. The formations prevent the little one from lying in a natural pose. Sometimes this happens when the child is very large or a short umbilical cord encircles his neck : it restricts his movements. Another reason is the woman’s numerous births, when her uterus suffered from numerous sprains. With an oblique or lateral position, a woman needs to perform all those exercises as with pelvic presentation. In this case, it is also recommended that more time lie on that side, towards which the back of the crumbs is turned. A woman is hospitalized 3 weeks before the expected birth. And if the situation has not changed, they are preparing for surgical intervention.
Fruit position with double
The position and type of the fetus are established during routine ultrasound diagnostics. Sometimes during such a study, future parents will learn about the surprise that nature has prepared for them: they will have twins! After euphoria, they begin to think about whether natural delivery is possible in this situation. Of course, this is quite real, but only in two cases: if both babies occupy the head presentation, or that baby, which is closer to the cervix, has this position, and the other is located forward. When the leading baby has a "pelvic pose", a cesarean is recommended. The thing is that during the birth of the first-born buttocks, children in the womb can catch on their heads, which is fraught with injuries. It is clear that with an oblique or transverse position, surgery can not be avoided. And even if the twins in the womb are in the right position, the decision on the method of delivery is made by the medical staff, taking into account many factors.