Given the normal location of the fetus in the womb, the baby's head is at the bottom and the first generic pathway emerges. But in three percent of all parturients, the fetus is located in the uterus in such a way that the legs (leg presentation), the buttock of the fetus (gluteal) or the legs with the buttocks (mixed pelvic presentation) are located above the bosom and rotated to the entrance to the woman's pelvis.
Childbirth can be resolved naturally without complications, but often situations that are dangerous for the mother and child.
Pelvic presentation of the fetus - causes:
- polyhydramnios and, consequently, increased fetal activity;
- presence of a narrow pelvis, abnormal location of the placenta, fetal development abnormalities;
- manifestation of malnutrition, abnormal development of the uterus;
- a decrease in the tone of the uterus.
How to determine pelvic presentation?
The obstetrician conducts external obstetric testing for a palpation of a large prepotent part of an irregular shape and a soft consistency above the entrance to the pelvis. A sign of pelvic presentation of the fetus is the high location of the bottom of the uterus. Palpitation of the fetus can be heard in women with pelvic presentation above the navel. Also, to clarify the diagnosis, appoint a vaginal examination and ultrasound.
How is pregnancy with pelvic presentation?
The course of pregnancy does not differ from the development of usual pregnancy. At the 32nd week, the future mother is prescribed a certain set of exercises and recommends wearing a bandage with pelvic presentation.
If before 37-38 weeks a small obstinate person does not change his position, the birth is conducted taking into account the pelvic presentation. 10-14 days before the expected date of delivery, the pregnant woman is hospitalized in the hospital, where the doctors decide the method of delivery.
Biomechanism of labor with pelvic presentation
In the hospital they decide to perform natural childbirth or cesarean with a pelvic presentation of the fetus.
At the same time, factors such as:
- what kind of childbirth, at what age;
- the course and outcome of previous pregnancies;
- the course of the current pregnancy;
- the presence of edema;
- presence of high blood pressure;
- renal dysfunction;
- estimated weight and condition of the fetus;
- the size of the mother's pelvis;
- in what condition is the cervix, and whether it is ready for childbirth;
- type of pelvic presentation;
- position of the fetal head.
If complications were experienced during pregnancy, the woman has a narrow pelvis, the weight of the child exceeds 3,500 grams, the age of the woman is more than 29-30 years old and she has the first pregnancy, then doctors in more than 80% of cases decide on the cesarean section.
Consequences of pelvic presentation
- If a decision was made to perform a cesarean section, then a scar remains on the woman's uterus.
- The condition of babies who were born in the pelvic presentation at natural delivery is not always satisfactory. Possible development of hypoxia can subsequently provoke nervous disorders in the child.
- There may be a dislocation of the hip joint and complications in the mother.
But if all precautions are met, the children are born healthy, and do not differ from the others.