Pelvic presentation

As is known, for a normal course of labor, the fetus must move forward along the generic pathways. He takes this position already at the end of pregnancy. But there are cases when, due to the polyhydramnios or the long umbilical cord, the child acquires increased mobility and at the beginning of childbirth is at the entrance to the pelvis, not with the head but with the buttocks or legs( gluteal and leg presentation respectively)( see figure)

Fig. Pelvic presentation

ReasonPelvic presentation can be a narrow pelvis of the mother, tumors of the uterus, large fetal head sizes, which, for example, occur with hydrocephalus( hydrocephalus), which prevents the head from entering the pelvis. Normal births in this position of the fetus are also possible, but more often they occur with complications: fetal asphyxia, birth trauma, traumas of the mother's birth canal, etc. Especially often pelvic predisposition occurs in multiple pregnancies. It can be revealed by any gynecologist when examining a pregnant woman. The head is not defined above the entrance to the pelvis, but much higher. Ultrasound makes it possible to clarify this assumption.

In childbirth, the diagnosis of pelvic presentation is evident, as the soft incisive part of the buttock is probed through the open cervix of the uterus. In addition to the wrong position of the fetus in the uterus, otherwise the pregnancy is normal. Various techniques that were used by doctors of past years to correct pelvic presentation to the headache are not currently used, since they can cause serious complications. The only thing a doctor can recommend to a woman is simple physical exercises that naturally help to turn the fetus into a normal position. During childbirth, complications often occur, therefore in modern midwifery pelvic presentation is one of the indications for cesarean section, especially when giving birth to a large fetus, narrow

mother's pelvis, age over 35 years, severe concomitant pathology. The pregnant woman should be in the hospital for 10-15 days before the proposed delivery. At the very onset of labor, premature rupture of amniotic fluid is often enough. The birth lasts longer, possibly the handles are thrown back. In any case, the doctor should try to finish the birth quickly, because with pelvic presentation inevitably there is an infringement of the umbilical cord, which leads to asphyxiation of the fetus. In a fairly large number of cases, severe trauma and rupture of the genital tract of the mother occur.