Breech presentation of fetus

Breech presentation of fetus

| |  Midwifery

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What is breech presentation?

Normally, the fetus is in the womb head down, that is, at birth pressed to the entrance to a small basin the largest part, that ensures adequate disclosure of the cervix and expansion of the birth canal for the birth of the body, arms and legs of the fetus. If the fetus is located the pelvic end down and a head rests against the bottom of the uterus, then talk about the breech presentation. The fetus must turn the head downward to 32-34 weeks.

Types of breech presentation

- Fully breech presentation (to the entrance to the small pelvis pressed against the buttocks of the child, and the legs are stretched along the body);
- Mixed breech presentation (on the entrance to the small pelvis pressed against the legs  and buttocks bent at the knee and hip joints).
- Foot previa (only two legs);
- An incomplete Foot previa (is one leg , and the other stretched out along the trunk);
- Knee previa (the child is kneeling).

Causes of breech presentation

Factors that contribute to the breech presentation can be divided into 3 groups:

1. Maternal factors

  • malformations of the uterus;
  • uterine tumors, which modify its shape;
  • narrow pelvis and pelvic abnormalities;
  • lowering and raising the tone of the uterus, in particular the lower segment (the threat of termination, a lot of labor, abortion and scraping the uterus);
  • a scar on the uterus after cesarean section;

2. Fetus factors

  • congenital malformations of the fetus (anencephaly, hydrocephalus);
  • improper location of the fetus (straightening head and spine);
  • premature birth;
  • lack of muscle tone of the fetus;
  • multiple pregnancy;
  • large fetus (more than 3.5 kg);
  • intrauterine growth retardation.

3. Placental causes

  • placenta previa and poor placentation;
  • polyhydramnios or oligohydramnios;
  • absolutely short umbilical cord (less than 40 cm);
  • cord entanglement;
  • true knots of the umbilical cord;
  • placenta is in the fallopian tube angles.

Features of doing pregnancy and childbirth

For a period of 32 - 37 weeks of pregnancy, doctors prescribe special gymnastic exercises for the "coup" of the fetus on the head. Hospitalization women with breech is held in 37 - 38 weeks. In a hospital are checked medical history, ultrasound, is carried amnioscopy is estimated fetal status and readiness of the cervix for childbirth.

The indications for elective caesarean section:

  • Weighed down obstetrical history;
  • Prospective fetal weight of 3.5 kg or more;
  • 3 degree of extension of the head;
  • Anatomically narrow pelvis;
  • Chronic intrauterine fetal hypoxia;
  • Prolonged pregnancy and so on.

When mature cervix and a normal state fetal childbirth lead by vaginal route after spontaneous onset.

Labor induction
is indicated for:

- immuno-conflict pregnancy;
- fetal abnormalities;
- prenatal outpouring of water.

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