Reasons for the transverse position of the fetus after. Factors contributing to fetal malposition

Normally, the baby reaches its final position in the uterus of a pregnant woman by 32-34 weeks. It is not for nothing that the last ultrasound falls during this period. But a situation often arises when the baby has not taken the appropriate position at the time of birth, that is, head down. Presentation can be cephalic (facial, frontal, occipital or anterior) and pelvic (foot, buttock and mixed). In this case, the position of the fetus in the uterus can be longitudinal, oblique and transverse. By the time of birth, about 95% of unborn children are in the correct position, that is, the head position, while the rest are in the pelvic position. It is worth noting that longitudinal breech presentation does not mean that natural childbirth impossible, but with an oblique or transverse one it cannot be avoided.

What are the features of childbirth with transverse presentation? Does it pose a threat to the mother and baby?

Transverse presentation: reasons

There are four main reasons for transverse presentation of the fetus at the time of birth. Most often it is provoked by insufficiency or excess of amniotic fluid. If the volume of fluid is too large, then the child has the opportunity to move arbitrarily in the uterine cavity and take any position. Low water levels lead to similar consequences. However, in this case, the fetus's capabilities are limited. Finding himself in a tight space, he cannot take the correct position. The second reason is the incorrect location of the placenta. If the placentation is low or the organ is attached too high, then the fetus may be in the head or breech, but transverse, because the length of the umbilical cord is limited. The third reason is the abnormal structure of the uterus. If, for example, it is two-horned, then the child cannot position itself correctly. The presence of tumors of the uterus, which also prevents the fetus from taking the appropriate position at the time of birth. The fourth reason for transverse presentation may be the pathology of the fetus itself. If the child is too large, has congenital hydrocephalus or anencephaly, then he cannot fit correctly in the uterus.

Among probable causes there may be multiple pregnancies, and the narrow pelvis of the woman in labor.

A doctor can determine the location of the fetus. An external examination allows you to find out what shape the uterus itself has - oblique-oval or oval. But the presentation is visible only on the monitor during an ultrasound. Palpation in in this case poses a danger, because there is a threat of rupture of the membranes and rupture of water. If the examination reveals transverse presentation, then exercises prescribed by your gynecologist can help. But they are only allowed up to 32 weeks of pregnancy. At a later date, their implementation is dangerous.

Complications and features of childbirth

If a woman is diagnosed with transverse presentation of the fetus, some complications may arise. Thus, there is a threat that amniotic fluid will be released prematurely, and the placenta will be rejected, leading to bleeding. As a result, the uterus will tightly compress the fetus, and this is fraught with injury and suffocation. In addition, with the flow of amniotic fluid, a shoulder, arm or umbilical cord may fall out of the uterine cavity. The worst option is uterine rupture, loss of fetal mobility and hypoxia. That's why with transverse presentation C-section is the best option. Waiting until the fortieth week of pregnancy is dangerous. Even in the absence of a hint of contractions, doctors insist on performing the operation at 37-38 weeks of pregnancy. Every day of delay in transverse presentation is real threat life of both the mother and the baby.

There is no need to worry about the outcome of the planned operation if the pregnancy is properly monitored. Already on the second day, the young mother will be able to breastfeed the baby, and after another 5-7 days she will be discharged from the maternity hospital.

Transverse position a fetus in the uterus is rare. If we look at the statistics, only 0.5% of pregnant women experience a similar phenomenon when the spinal axis of the mother and child are not parallel to each other. In general, transverse and oblique position The fetus is considered problematic in obstetrics. Natural childbirth is almost impossible, as it is very risky. Usually the baby is born by caesarean section. However, there are often cases when a woman has a transverse position of the fetus, exercises and special gymnastics they helped fix it, and she gave birth on her own. One of effective methods to correct the child’s position is a set of exercises (they will show you how to do everything correctly in the physical room antenatal clinic) and rest on the side where the baby’s head is located.

What is meant by transverse presentation of the fetus and what are its causes?

The transverse position is the position of the baby when he is located in the uterus not along its axis, but at an angle. Its head and buttocks are located across the exit from the uterus and pelvic organs. This position of the fetus is revealed during screening.

The condition of a pregnant woman whose baby lies down in a transverse position does not affect her health in any way. Pregnancy can proceed absolutely calmly during the first two trimesters. But the third trimester can present a lot of bad things pleasant surprises. This includes bleeding and premature birth, and even a threat to the life of both mother and fetus. Among other troubles, there are early departure amniotic fluid, prolapse of parts of the child’s body, umbilical cord, damage and rupture of the uterine organ.

It doesn’t matter whether the fetus is transverse, oblique or unstable, the pregnant woman should be constantly under medical supervision. Hospital treatment unconditional in case of the slightest suspicion of bleeding.

If there is an abnormal position of the fetus during the second trimester, then there is hope that the baby will still take some time before birth. correct position. The baby in the womb is constantly in motion. It swims in the amniotic fluid, often changing its position. But after 33-35 weeks, the baby is unlikely to be able to change its position in the mother’s tummy. He's already grown up enough and it's cramped for him.

Doctors clearly determine the reasons for the transverse position of the fetus. Firstly, this is overstretching of the uterus as a result of previous pregnancies and a large number of amniotic fluid (at the same time, such a presentation can lead to oligohydramnios). Secondly, early terminations of pregnancy, numerous abortions and spontaneous miscarriages may cause transverse presentation of the fetus. Thirdly, if a woman has an incorrect pathological form uterus (saddle-shaped, horn-shaped, bicornuate), that is, the risk that the child will take an incorrect position in the womb.

A diagnosis of “transverse fetal presentation” can be made by screening, palpation or vaginal examination. It is also possible to visually see that the fetus is incorrectly positioned with the naked eye. Mom's belly has an oval, angular shape and is abnormally stretched.

An experienced gynecologist or obstetrician can easily determine the position of the fetus. First, the doctor uses his hands to find the location of the head, and then feels the limbs - the baby’s heels or buttocks.

It is also noted that the fetus is in abnormal position after the amniotic fluid has broken. Dropping out individual parts body: shoulder, arm leaves no doubt that the child is lying transversely.

What are the dangers of transverse and oblique presentation?

Although the pregnancy is proceeding normally, the mother and the doctor under whose supervision she is not allowed to relax. Premature labor and water breaking can occur at any time. When early birth decisions must be made quickly. Most likely, a caesarean section will be scheduled. This is especially true in cases where during the examination placenta previa and obstruction of the baby’s exit from the uterus into the birth canal were noted. Incorrect actions of doctors, unqualified assistance or incompetent actions can lead to serious problems. The uterus may not be able to withstand and rupture, it may begin uterine bleeding, which is quite difficult to stop. Moreover, from loyalty decisions made life depends not only born child, but also mothers.

It should be noted that natural birth with a transverse or oblique presentation of the fetus also occurs in medical practice. If the baby is premature or has very little weight If the uterus is sufficiently dilated, doctors can manually turn the baby. However, there is no guarantee that after changing his position he will not return to his previous position. In cases where a child's leg or arm has fallen out, it is unacceptable to set it back.

I would like to warn everyone who, out of fear of surgical delivery, decides to take risks and agrees to give birth naturally, allowing you to manually turn the fruit. This is unreasonable. It is the child who suffers first. External obstetric inversion is prohibited in most countries due to the very high risk complications.

Pregnancy is one of the happiest stages in a woman’s life. But during this same period, problems occur that overshadow the happiness of future motherhood. One of these problems is transverse presentation of the fetus. It leads to problems during childbirth and poses a threat to the life and health of the child and mother.

Why is the child in this position?

The baby’s position is finally determined at 32 weeks of pregnancy, since more early stages he can change it repeatedly on his own. Most often, the baby takes a normal position - with the head towards the birth canal.

But it happens that it can be transverse or oblique. Transverse is characterized by the fact that the transverse axis of the baby’s body is at a right angle to the axis of the uterus. Oblique presentation - under acute angle. Both cases are pathological.

This is usually explained:

• . This condition creates conditions for the fetus to actively move.
• Flabbiness of muscles. Most often, flabbiness is characteristic of the second and subsequent pregnancies, when the mother’s muscles are no longer able to fix the fetus in one position, and it continues to move even at longer periods.
• . During pregnancy, the baby seeks the most comfortable position for itself. Nodes in the area of ​​the uterus, which are formed by a tumor, interfere with it. In this case, the fetus will take a position so that the head does not touch them.
• Deviations in the structure of the uterus. Pathologies such as saddle-shaped and bicornuate uterus are common. If the shape of the uterus is non-standard, then the baby may also feel uncomfortable in in the right position be in the womb. He will move to take the most comfortable position.
• Deviations in fetal development.
• Premature birth. The child does not have time to turn over after the water breaks.
• The structure female body. If a woman has too much, the fetal head cannot take the desired position.
• Multiple pregnancy. Two or three fetuses prevent each other from taking the correct position in the womb.

Types of fetal presentation

There are three types of fetal presentation:

1. – when the axis of the fetus and the mother’s uterus coincide and lie on the same line. Normally the head should be there. When the baby lies with his buttocks forward, this also complicates the birth process.
2. Transverse - the baby is at an angle of 90° to the mother's uterus. The head and buttocks are located on the sides above the iliac bones of the small pelvis.
3. Oblique - when the child is at an acute oblique angle in relation to the mother, the head and buttocks are not on the same line. One part is on top, the other is below.

The doctor makes the final decision about the position of the fetus in the second half of the third trimester of pregnancy. Previously, this makes no sense, since the child can still take a normal position.

How is presentation diagnosed?

There are several ways to understand how the baby is positioned in the womb:

1. Screening ultrasound. The most popular method, since the position of the fetus becomes immediately visible.
2. Palpation. The doctor finds the location of the baby and his body parts by touch.
3. Examination through the vagina.

An experienced doctor can identify pathology by the shape of the abdomen.

Why is transverse presentation dangerous?

In medicine, there is a practice when specialists independently turn the child into the correct position using an external method. However, now such manipulations are used extremely rarely, since the risk of complications for both is high.

The child may experience serious injuries as a result of such a procedure. In the mother, this can lead to uterine rupture. In addition, the fetus may suffocate, in which case even surgery will not help save it. In addition, the procedure is quite painful.

After malpresentation is diagnosed and the fetus is fixed in the uterus, the doctor determines how pregnancy and childbirth will proceed.

In the absence of contraindications, the pregnant woman is prescribed a special one, which helps turn the fetus in the right side. In addition, the doctor explains to the woman which side is best to lie on according to the position of the baby’s head.

Here is one of the most common sets of exercises that can help a child turn in the right direction:

1. Lie on a hard surface, a couch or sofa on either side and lie in this position for 5 minutes. Then slowly and carefully roll over to the other side and lie on it for the same amount of time. The sides need to be changed several times. It is recommended to repeat the procedure 3 times a day.
2. Lie on your back. Place a rolled blanket under your buttocks and lie there for up to 10 minutes. Repeat also 3 times a day.
3. Get on all fours with support on your elbows and knees and stand like this for several minutes.

Such gymnastics will create favorable conditions so that the child takes a normal position. However, before starting exercises, you should consult your doctor.

Some elements physical activity may be contraindicated for pregnant women due to health problems. The specialist will select gymnastics individually, taking into account your medical history and general well-being future mother.

Childbirth with transverse presentation of the fetus

Transverse presentation poses a great danger to both the pregnant woman and the fetus itself. If the situation does not change before the onset of labor, it is not recommended to give birth on your own, as there is a high risk of complications.

Spontaneous childbirth is possible only when the baby’s weight is very small or begins in the early stages of pregnancy.

But it is important to take into account the level of uterine dilatation. Even if the baby's weight is acceptable, but dilatation does not allow for spontaneous labor, an emergency caesarean section will be required.

In case of transverse presentation of the fetus, in most cases a planned caesarean section is prescribed. At 37 weeks of pregnancy, hospitalization is performed and expectant mother preparing for surgery.

In the case of premature birth, doctors usually decide on emergency surgery, since natural childbirth in this position is unacceptable.

Unlike oblique presentation, there is very little chance that the baby will last moment will take the correct position in the womb.

A planned caesarean section is performed on an empty stomach. Before surgery you need to empty your bladder and intestines. Anesthesia is then administered.

Nowadays it is made to choose from: general or . The second is the most popular because it has fewer risks for the child’s health. After the anesthesia has taken effect, the surgeon cuts and spreads the muscles, then the uterus, about amniotic sac and removes the child.

Reply

Pregnancy is a dynamic process that culminates in childbirth. The course of pregnancy affects the course and tactics of delivery. One of the important parameters is the position of the baby in the uterus.

The position of the fetus is the ratio of the length axis of its body to the long axis of the uterus. Presentation is the ratio of the part of the fetus directed towards the exit from the uterine cavity. Position and presentation can be correct or incorrect.

The possibility of a natural birth depends on the position of the baby in the womb. If the baby's position is incorrect, a caesarean section is indicated.

Classification of positions and presentations:

• The correct position is longitudinal, oblique, unstable;
• Incorrect position – transverse;
• Correct presentation is cephalic;
• Incorrect presentation – breech, low, pelvic.

This classification is generalized, since there are several more subtypes of pelvic and malpresentation. These subspecies do not significantly affect the tactics of labor management. Not stable position is a variant of the norm because it is limited to the time period of gestation.

Transverse presentation of the fetus

The relationship of the longitudinal axis of the child to the longitudinal axis of the uterus with the formation of a right angle is called the transverse position. In this case, the baby is located across the pelvis.

If such a position is observed before the birth itself, then the latter is only possible operationally. Pregnancy can proceed favorably, but there is a possibility of premature birth, which poses a threat to the life of the woman and the child.

Quite often, the transverse position of the baby in the womb is called transverse presentation. This is not entirely true. Presentation is only cephalic and pelvic.

Causes of transverse presentation (position) of the fetus

This phenomenon can be caused by a large number of factors. First of all, these include conditions under which the baby can move excessively: malnutrition of the baby, too much water, weakness of the muscles of the abdominal wall (eg. repeat pregnancy) etc.

On the other hand, this condition may also be caused by a lack of intrauterine activity, for example, with oligohydramnios, large child, increased tone uterine muscles, threat of miscarriage, abnormalities in the structure of the uterus (bicornuate or saddle-shaped), fibroma, etc.

In addition, cephalic or pelvic transverse presentation (position) of the fetus can occur due to anatomical reasons that prevent the position of its head in the mother’s small pelvis. For example, when clinically narrow pelvis, location of the placenta along the anterior abdominal wall, tumors of the pelvic bones or lower segment of the uterus.

In addition, the reasons may be hidden in developmental anomalies of the baby (eg hydrocephalus, anencephaly).

Diagnosis of pathology

Pelvic or cephalic transverse presentation of the fetus can be established through an obstetric examination, palpation of the abdomen and vaginal examination. In this case, the abdomen becomes transversely stretched (obliquely stretched) of irregular shape.

The uterus has a spherical shape, which should not be the case. The norm of abdominal circumference, as a rule, exceeds the norm in accordance with the period, in addition, the height of the uterine fundus is insufficient.

During palpation, the doctor cannot determine the presenting part of the baby: the head is palpated away from the median axis of the woman’s body, and the baby’s pelvis is palpated in the lateral parts of the uterus. In this case, the baby’s heartbeat can be heard in the navel area.

Difficulties in determining the baby's position can arise with multiple pregnancy, polyhydramnios, and uterine hypertonicity. Confirm or deny availability pathological condition possible using obstetric ultrasound.

A standard gynecological examination, which is carried out throughout pregnancy, as well as in the initial period of labor with a intact amniotic sac, is uninformative. It allows you to establish only that there is no presenting part in the woman’s pelvis. After the waters recede and the uterine os opens to 4-5 fingers, with the baby in a transverse position, his shoulder, rib, shoulder blade, armpit, spinous processes of the vertebrae, elbow or hand may appear.

Why is transverse presentation of the fetus dangerous for women and children?

Typically, pregnancy in this case proceeds favorably. Happens often premature effusion water and, accordingly, premature birth. If in addition to all this there is placenta previa, heavy bleeding develops.

In turn, the sudden release of water sharply limits the baby’s mobility in the womb, which can lead to the baby’s shoulder being driven into the woman’s pelvis, or the arm or umbilical cord falling out.

When parts of the child’s body fall out, chorioamnionitis, diffuse peritonitis, and sepsis may develop. If the water-free period lasts more than 12 hours, there is a high probability acute hypoxia and even asphyxia of the child. Launched transverse position with increasing labor activity It is dangerous because uterine rupture may occur.

Quite rarely, but it happens that during the process of delivery the baby spontaneously turns into the head or pelvic position, or the baby is born with a double body. Similar result It is very rare and is possible with strong contractions, extreme prematurity or a dead fetus.

Childbirth with a diagnosed transverse presentation of the fetus

Until 34-35 weeks of pregnancy, the oblique or transverse position is considered unstable, as it can change to the correct one. If such a pathology is detected, it is necessary to carefully examine the pregnant woman and determine the cause of the anomaly, choose the tactics for managing the woman and the method of delivery.

Usually, at 30-34 weeks of pregnancy, special gymnastics is prescribed, which will help the baby turn around.

Contraindications to corrective gymnastics:

• Threat of miscarriage;
• Scar on the uterus;
• Myoma;
• Decompensated heart defects in the expectant mother;
• Bloody discharge, etc.

Approximately 4-5 weeks before birth, the baby takes a stable position, therefore, if the pathological condition persists, the woman is hospitalized to determine delivery tactics.

Previously, they resorted to external rotation on the head, but now this is rare, since this method is ineffective and can lead to placental abruption, uterine rupture, and fetal hypoxia.

The optimal method for bringing a baby into the world under such circumstances is a caesarean section. Indications for the latter are: placenta previa, premature rupture of water, uterine scar, oxygen deficiency in a baby, post-term pregnancy. If parts of the fetal body fall out, their reduction is unacceptable.

When the uterus is dilated by 10 fingers and the baby is alive and mobile, it is possible to turn it onto its leg and further extract it. However, such manipulations and natural childbirth can only be carried out in cases of multiple births and prematurity.

If there was a long anhydrous period, and later an infection joined it, then after operative delivery The woman undergoes hysterectomy, and there is also a need for drainage of the abdominal cavity.

If the baby is located perpendicular to the axis of the uterus (across), this phenomenon is called transverse position of the fetus. Even 2-4 centuries ago due to difficult birth, provoked by such a complication, many mothers and their unborn children died.

Modern medicine has found a way to significantly reduce the mortality rate during childbirth, but the risk still remains high. Therefore, you need to be attentive to this phenomenon, and know how to behave and what needs to be done.

Why does transverse position of the fetus occur?

Until 30–32 weeks of pregnancy, the little man is too mobile and constantly changes his position. This means that it can easily rotate into the correct position. So there is no need to panic during this period. You should worry if after 33 weeks the situation does not change.

It has been noted that incorrect positioning of the baby in the uterus occurs in only 1 out of 200 women giving birth, that is, 0.5 - 0.6% of cases are recorded. Mothers giving birth for the second time are 10 times more susceptible to disruptions in the normal course of pregnancy.

Healthy women are less likely to develop complications. Below in the video you can watch and listen to a specialist who will talk in detail about the pathology.

There are several reasons that lead to the incorrect placement of the child in the womb:

1. Uterine fibroids. Formation of myomatous nodes in lower area the uterine pole and near the cervix often provokes malposition of the fetus. Especially in the case of profiling fibroids, the rapidly growing tumor does not allow the baby to turn in the right direction.
2. Abnormal development of the uterus. For example, if a pregnant woman has a bicornuate uterus, with a septum. This phenomenon can make it difficult for the fetus to lie down correctly.
3. Placental presentation. The presence of the placenta near the uterine os prevents the baby from adopting the correct physiological position.
4. Polyhydramnios. A large volume of amniotic fluid contributes to excessive activity of the baby in the womb. He does not feel the uterine walls, which disrupts the correct perception of the surrounding space. This can lead to choosing the wrong posture.
5. Multiple pregnancy. When a woman has twins, there is a maximum risk of incorrect positioning of the children, since they interfere with each other in taking longitudinal positions. If, during the development of several children, premature birth occurs, the chances of their acceptance correct position extremely small.
6. Parity of births. The more times a woman gives birth, the weaker the muscles of the organ become. This leads to maximum intrauterine mobility of the baby, which threatens its incorrect location.
7. Narrow pelvic ring. If a pregnant woman has a third and more degree narrowing of the pelvic ring, the child cannot lie down correctly, which leads to complications.
8. Developmental disorder vestibular apparatus baby. This pathology extremely rarely leads to such a situation, but this possibility should not be discounted.
9. Large or small fruit. With excess weight and size, it is difficult for the future little man to move, which is why he takes the wrong position. When the baby is small, his activity increases, as a result of which he constantly spins, rolls over, and by the end of the term he may also take the wrong position.
10. Hypertonicity of the uterus. The threat of premature termination of pregnancy provokes an increase in the tone of the uterus, which greatly limits motor ability baby.

What is oblique position

TO incorrect location The fetus includes not only a transverse, but also an oblique position. In this case, the baby’s body is at an angle of 45 degrees relative to the axis of the womb. And the head or buttocks of the future little man are located slightly below the iliac crest.

In obstetric practice there are also transverse oblique position. In this case, the angle of inclination of the fetus will be more than 45 degrees. But in both cases, the baby’s position is unstable, and with intense mobility it can lead to a turn in a transverse or longitudinal position.

You can distinguish transverse from oblique with external gynecological examination belly. Large parts (head and buttocks) will be palpated from the sides of the abdomen.

What is the danger of such a diagnosis?

Such a diagnosis complicates not only childbirth, but also the course of pregnancy, as it increases the risk of such phenomena as:

• premature birth– when the child lies transversely, pressure from the uterus occurs earlier than when lying longitudinally, which contributes to the premature pushing out of the womb due to its inability to quickly stretch;
• early rupture of membranes– occurs due to the lack of uniform distribution of amniotic fluid, creating a load on the lower pole of the bladder;
• neglected transverse position– when the amniotic sac ruptures, the baby’s limb may fall out, which makes it difficult to move and can cause death.

How to diagnose the disease

In the first and second trimester, diagnosing transverse lying is ineffective, since the baby is in constant motion and can change position at any time. No symptoms appear with this pathology of pregnancy; it can only be detected during a gynecological examination.

Determining the problem during inspection is carried out in several ways:

• visual inspection;
• palpation of the abdomen;
• ultrasonography;
• vaginal examination.

Each of these methods has its own characteristics and disadvantages.

Abdominal examination

During a routine examination of the abdomen, the irregular shape of the uterus, expanding in the center to the sides, is clearly visible. It is impossible to determine the location of the head with such an examination. But a transverse or oblique arrangement is easily visible, since the organ becomes transversely stretched or obliquely stretched.

How to understand that there is a pathology? Head presentation noticeable by the uterus elongated along its axis. However, if the position is incorrect, the uterus becomes spherical. When measuring the abdomen, a deviation from the norm occurs - the abdominal circumference is slightly higher than the norm, which should correspond to the period of pregnancy.

Palpation of the abdomen

The presenting part cannot be determined by palpation little man, and the head is palpated on the side of the center line of the pregnant woman’s abdomen. When the head is located on the left, this is considered the first position. When determining the head on the right, the second position is recorded in the pregnant woman’s card.

For transverse presentation, it is typical to hear the baby’s heartbeat near the mother’s navel, while with longitudinal lying, the heart can be clearly heard on the left or right side of the abdomen.

The disadvantage of this examination method is the inability to determine the position of the fetus in transverse presentation in case of excess amniotic fluid, development of several fetuses and increased uterine tone.

Obstetric ultrasound

On ultrasound, the position of the fetus is determined very well, even with multiple pregnancies and other factors. Guaranteed 100% determination of the location of the baby does not depend on the stage of pregnancy.

It is worth noting that an ultrasound done at 20 weeks or earlier should not bother the expectant mother. This period is too short to determine pathology. But when identifying a clinic for more later worth sticking to certain rules and doctor's recommendations.

Vaginal examination

Information about the placement of the baby can be obtained through a vaginal examination. It is carried out shortly before the end of pregnancy and at the moment of the onset of labor, when the amniotic fluid has not yet receded.

If the presenting part of the fetus is not felt when palpating, this indicates its incorrect placement.

If pessary dilated by 4 cm or more, and the amniotic sac has burst, the examination is performed very carefully so as not to provoke complications of labor associated with the prolapse of the umbilical cord or fetal limb. Erupted water allows the obstetrician to feel top part baby's body - ribs, armpits, hand.

Watch a video about fetal malposition:

How is pregnancy progressing?

The transverse position of the fetus in the womb rarely disrupts the process of pregnancy as a whole. But it is typical for such a disease to cause early termination of pregnancy in the later stages, in approximately 30% of all cases.

There are no obvious features of the course of pregnancy. And, starting from the 38th week, amniotic fluid may break, resulting in the need for immediate hospitalization of the pregnant woman. Regional presentation The placenta in a transverse position can also aggravate the pregnancy process. With increased pressure on bottom part uterus, the placenta may move towards the uterine os, causing bleeding.

If transverse presentation was diagnosed at 28 weeks, to the expectant mother You should adhere to some rules of behavior:

• to avoid rupture amniotic sac reduce physical activity;
• do not lift heavy objects;
• to sleep more;
• do not neglect doctor’s examinations;
• perform exercises to correct the position of the fetus.

Regarding the question of whether it is possible to wear a bandage if the child is diagnosed as lying transversely, it is better to consult a doctor. But often wearing a bandage is specifically prescribed by a gynecologist, since it helps to distribute the weight of the abdomen evenly, which reduces the load on its lower part. Second positive effect- reduction of back and abdominal pain.

But it is worth considering that with anterior low placenta previa and other pathologies, the bandage cannot be worn.

The choice of bandage should be taken carefully. Those who have already given birth recommend trying it on when purchasing or consulting with an observing obstetrician-gynecologist who will tell you the correct size.

Separately, it is worth mentioning the possibility of changing the position before the onset of delivery. For this purpose, experienced obstetricians carry out external turn fetus Previously, this technique was often practiced, but modern obstetrics treats this method with disdain.

Associated with infrequent use obstetric revolution with numerous contraindications:

• several children in the womb;
• placental presentation;
• low placentation;
• threat of early delivery;
• pathology of fetal fluid;
• problems with umbilical cord vessels;
• bleeding.

Complications may occur during or after the procedure. For example, placental abruption or uterine rupture. Therefore, performing a coup requires maximum skill from the obstetrician. To avoid negative consequences, you need to know the location and position of the baby, and be able to turn it so that its back is not behind (turned towards back wall uterus).

If, as birth approaches, the baby does not take the correct longitudinal position, and there is no way to turn it, then a caesarean section is prescribed when the diagnosis is made.

Possible complications

The main reasons associated with improper positioning of the baby in the womb can lead to the following complications:

1. Untimely discharge of amniotic fluid, especially rapid discharge, can lead to the prolapse of the child’s limb through an open pharynx.
2. Neglected transverse lying leads to compression of the umbilical cord due to its prolapse, which disrupts blood flow and can lead to the death of the baby.
3. Rupture of the internal genital organs occurs as a result of an advanced transverse position, when, due to the impact of the fetal shoulder into the mother’s small pelvis, the uterus begins to actively contract (this leads to its strong stretching in the lower segment). Only a timely caesarean section will save the mother and baby from death.
4. As a result of long anhydrous period Over time, an infection can penetrate inside, causing choriamnionitis, leading to peritonitis and blood poisoning.
5. Prolonged labor can lead to fetal hypoxia.
6. The death of a baby can occur due to bending of his body in the thoracic region at the moment of the beginning of passage through birth canal. Such an excess leaves no chance of survival.

Labor management tactics

IN in rare cases childbirth ends on its own without any pathological consequences. But such an outcome of events is only possible when the fetus has small size or premature. Then he can independently turn during labor into a longitudinal position, and emerges with his head or buttocks forward.

If a child is bent in half and walks backwards, he receives multiple injuries that are incompatible with life. Childbirth ends with the death of the child.

In other cases, a cesarean section is performed to provide assistance in case of incorrect position.

The most common complication of existing pathology is premature rupture intrauterine waters. This can trigger labor in a woman. If there are no danger signs complications, it is possible to perform an obstetric revolution during the birth process. It is called “combined revolution”, since the process involves turning the baby with one hand inside the womb and the other outside. This method is used more often in cases of multiple births, if the first baby has already been born independently, and the second lies across.

Corrective gymnastics for transverse position of the fetus

There is a way to turn the baby over without resorting to an obstetric revolution and other methods. Since treatment is not carried out in this case, the situation can be corrected with corrective gymnastics.

However, there are certain contraindications to performing these exercises:

• discharge and bleeding;
• excess or lack of amniotic fluid;
• tumors, scars and neoplasms in the uterus;
• increased uterine tone;
• multiple births;
• pathologies of the placenta;
• disruption of the activity of the umbilical vessels.

Therefore, when prescribing such gymnastics, the woman’s medical history and pregnancy management must be studied.

The gymnastics complex includes various swimming, physical and breathing exercises, such as:

• tilting or lifting the pelvis;
• "kitty";
• half bridge;
• knee-elbow pose and others.

Gymnastics using the method of I.F. Dikan, which is performed from the 29th week, has proven itself well. It consists of repeating turns three times from one side to the other, when lying on your side takes 15 minutes between turns.

There are other methods, but all of them can only be performed with the recommendation of a doctor.

It is important to know how to sleep when lying transversely. The baby is most comfortable with his head down, so the mother should choose a sleeping position according to the baby’s position, that is, sleep on the side where his head is.

Conclusion

Surgical intervention in the transverse position is fully justified. This approach significantly reduces the mortality rate of one or both participants in childbirth (mother and child), and also contributes to the absence of complications during labor. Numerous people talk about this positive reviews women who gave birth safely.