Breech presentation for 32 weeks. Possible causes of the problem

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Questions and answers on: breech presentation of the fetus at 32 weeks of pregnancy

2012-08-03 05:35:24

Irina asks:

Hello! I am 29 years old. She gave birth to her first child at 23 years old, they did C-section(according to the state of vision). Now pregnant with my second. At the first ultrasound at 12 weeks everything was normal. At the second ultrasound (21 weeks), the diagnosis was made: “on the anterior wall of the uterus in the middle part on the right there is an intramural-subserous node measuring 19*13 mm, predominantly of reduced echogenicity. On the anterior wall in the middle part there is an intramural-myomatous node with a diameter of 8 mm. The tone of the uterus is not increased . Breech presentation of the fetus. Uterine fibroids." Please tell me how dangerous the diagnosis is for the baby’s health and for his full development? How will this affect the further course of pregnancy and will this cause premature birth? And is a caesarean section performed for such a diagnosis?

Answers Kolesnik Victoria Leonidovna:

Good afternoon, Irina! For uterine fibroids, a caesarean section is performed. Nodes can cause premature birth. In your case, a doctor's supervision is necessary. antenatal clinic, prenatal hospitalization, repeat ultrasound. This will make it possible to determine how the child is developing and, if necessary, prescribe therapy aimed at optimizing the functioning of the uteroplacental complex, which will contribute proper development baby.

Answers Silina Natalya Konstantinovna:

At 22 weeks we do not place a cephalic or pelvic presentation as the baby constantly changes presentation. Uterine fibroids are not an indication for cesarean section. after 34 weeks, depending on the obstetric situation, the question of the method of delivery will be decided. On this moment there is no reason to worry. The criterion for the risk of premature birth is the length of the cervix less than 30 mm. Repeat cervicometry at 30 weeks.

2010-09-22 07:46:51

Natalia asks:

Good afternoon I have the following situation: at week 12, an increased TVL was discovered to 6 mm, I did a chorionic villus biopsy, the result was 46.XX. All subsequent ultrasounds showed that the fetus was normal. At 31 weeks, shortening of the tubular bones was detected (corresponding to a period of 29-30 weeks). At week 37 - corresponded to 32 weeks, while the cerebellum corresponded to 37 weeks. A diagnosis was made: skeletal dysplasia, which causes pulmonary hypoplasia. I have a bicornuate uterus (the baby sits on the left side of the uterus throughout the pregnancy), and the fetus is breech. On the female side of the family, all women short(150-155 cm). Please tell me if I have a chance to give birth healthy child? And can my girl just be small (constitutional features)?

2008-08-28 14:30:17

Irina asks:

Good afternoon
Please tell me whether it is possible to harm pregnancy at 21 weeks by receiving a clitoral orgasm, provided that the placenta is low (25 mm above the internal os) and the fetus is breech.
Thank you!

Answers Zhegulovich Yuri Vladimirovich:

Good afternoon, Irina! From a medical point of view, you have a significant contraindication for sexual relations(including clitoral orgasm) is low attachment placenta. With this location of the placenta and orgasm, which is usually accompanied by contractions of the vaginal and uterine muscles, the risk of miscarriage increases. It is especially dangerous if the orgasm coincides with the days when menstruation would have occurred if pregnancy had not occurred. So, unfortunately, you should limit sexual activity and give the joy of sex only to your husband. Rely on your imagination and knowledge of each other, be understanding of your partner’s desires and attentive to yourself. Don't overdo it - sex is not a mandatory activity during pregnancy, there are still a great many ways to express yourself. mutual love! After all, now you need to take care not only of yourself, but also of the baby. Therefore, spend more time on fresh air, travel around interesting places, eat well, take special complexes for pregnant women, learn to relax. Also, do not forget about preparing for childbirth, visiting the nursing home and following the doctor’s recommendations. Good luck to you!

2016-03-10 14:34:31

Elena asks:

Hello! Please tell me what does loose placenta mean? This was written on the ultrasound at 20 weeks. Pregnancy 1st. Ultrasound results: fetal position: unstable, presentation: breech, II position, posterior view, amount of amniotic fluid: normal, water pocket: 32, 39 mm; localization of the placenta: anterior wall of the uterus, degree of maturity of the placenta: I, thickness of the placenta: 24-29 mm, acentric attachment of the umbilical cord 20 mm from the edge (this is how they explained to me the danger of tearing off a piece of the placenta during childbirth, you can’t pull the umbilical cord?), cervix : 39.2*30 mm. All other indicators and blood and urine tests are normal, nothing to worry about. The doctor prescribed Glutargin 0.75 3 rubles so that the placenta attaches better. in the village - 2 days. and constantly drink Elevit throughout your pregnancy. Should I take these drugs? Is placental abruption possible in this case?

Answers Palyga Igor Evgenievich:

Hello, Elena! I don’t know the tactics of your attending physician and your medical history, but glutargin and multivitamins have nothing to do with placental abruption.

2013-09-23 19:11:19

Christina asks:

Good day! Please tell me if this is a normal ultrasound conclusion at 20 weeks of pregnancy (today is exactly 20 weeks)?? 22 years old, pregnancy completed, my weight before pregnancy was 49 kg, now I’m 54!
Fetus 1, longitudinal position, pelvic presentation, fetal size - BDP 4.22 cm (is this normal at my term?) - corresponds to a period (for some reason) of 18 -19 weeks. Abdominal circumference - 14.79, length femur 3.17, head circumference 16.62 cm, humerus length 2.93 cm, ----dimensions correspond to 19-20 weeks! Falling top. and lower, etc. limbs are veiled. The head is located at the bottom. The skull is veiled. Brain. the middle m-echo is not displaced, the width of the large ciscern is 0.5 cm, the width of the posterior horns is 0.53 cm. The cavity of the transparent septum up to 0.26 cm in size, the spine can be traced. The fetal heartbeat is rhythmic up to 142 beats.min. The size of the heart is normal. The stomach is visible. A small amount of hyperechoic content is detected in the intestine (is this normal*?). The right and left kidneys are veiled, the contour is not clear. There are movements, movement is normal. floor - m))))))) The placenta is located on back wall The uterus is 4.4 cm above the edge of the internal os. (Is this good?) The thickness of the placenta is 2.3 cm. The intervillous space is wide (is this normal?) The umbilical cord has 3 vessels. amniotic fluid fine! amyotic fluid index 11 cm.
cervix - length 3.9 cm, thickness 3.4 diameter of the internal os - open and the following comments - This study does not exclude the possibility of the fetus having minor unidentifiable defects, including congenital heart disease, which may not be diagnosed due to the peculiarities of the fetal blood circulation. Conclusion - pregnancy 19-20 weeks Recommendations - ultrasound monitoring in dynamics. Tell me, or more precisely, is it possible in Russian? Is this normal???? What are the concerns of doctors with such a comment????? help, I'm very worried

Answers Gritsko Marta Igorevna:

If the placenta is located in this way and the internal os opens by 4.4 cm (this is not the norm!), you need to go to the hospital as soon as possible!
The size of the fetus corresponds to the period of 19-20 weeks, the conclusion about minor defects sounds strange, they are either present and visualized, or they are not.
Have you undergone screenings - combined and triple tests? It is advisable to consult a geneticist with all examinations.
I wish you success!

2013-01-03 11:46:03

Zilya asks:

Hello! I certainly don't expect an answer, but I'll try. I am 31 years old. Third pregnancy. The previous two ended in caesarean section. I have two daughters. There were no problems with the first pregnancy. Caesarean section was performed due to breech presentation and large fruit 4200gr. During the second, there was always a threat, uterine tone. It's six weeks now. I haven't gone to the hospital yet. Permanent nagging pain lower abdomen, tone and a few days ago there were small discharge light Brown. There's still a long way to go until the end of the weekend. What to do? I'm not drinking anything yet. Lie. Thanks in advance.

Answers Gritsko Marta Igorevna:

Of course, you need to see a gynecologist and undergo an ultrasound scan. There is a possible risk of miscarriage. For now, take 1 tablet of Duphaston. 2 times a day and rectally homeopathic suppositories Viburkol.

2012-12-13 11:36:51

Christina asks:

Hello, I am turning to you for advice. The fact is that they cannot give me a final pregnancy date. I am 21 years old, this is my first pregnancy, I was 20 years old at the time of conception. There were no abortions.
First day last menstrual period July 5, 2012, but I’m sure that conception could not have happened, since I had sex only after the 10th.
At the first ultrasound (October 17, 2012), the menstrual period was set at 14 weeks 6 days, and according to the ultrasound results, 13 weeks 3 days.
At the second ultrasound (December 9, 2012), the period was 22 weeks 3 days, but here are the ultrasound results:
BPR 48mm;
LZR 61mm;
OG 176mm;
Coolant 148mm;
DB/coolant*100%=21.6%
Thigh length right and left 32mm;
The length of the lower leg on the right and left is 28 mm;
Length of humerus sp. sl. 30mm;
Forearm length sp. sl. 26mm;
The length of the nasal bone is 7.8 mm;
Thickness of the neck fold (up to 21 weeks) 4.5 mm;
Heart rate 134 beats per minute;
Distance from the lower edge of the placenta to the inside. throat 70mm;
Placenta thickness 24mm;
0 degree of maturity;
Amniotic index liquid 148mm;
Umbilical cord 3 vessels;
Cervical length 36mm;
Localization of the placenta along the posterior wall;
The position is longitudinal, pelvic presentation.
The spine is located at 8 o'clock
Gender is girl.
The conclusion is 19-20 weeks of pregnancy, and according to the first ultrasound it should be 21-22 weeks.
Could this be a delay internal development fetus?

Answers Gritsko Marta Igorevna:

That’s right, according to the term it turns out to be 22 weeks, according to ultrasound data it’s 20 weeks. Results of combined and triple tests were they normal? If yes, then there is no need to worry, you need to assess the situation in dynamics. I don't think it's a delay intrauterine development. Have a follow-up ultrasound scan in a month.

2012-04-22 07:48:27

Anna asks:

Good afternoon. Please tell me I'm 24 weeks pregnant. All screenings and ultrasounds are normal. A week ago, at night after urinating on a napkin, I began to notice yellow discharge with an admixture of ichor. They did an ultrasound, everything was normal with the fetus, there was no abruption, a urine test, a culture tank and a vaginal smear were normal. What could it be? There is no pain in the lower abdomen either. Discharge occurs only at night; there is no discharge during the day. I have a breech presentation, the baby often hits bladder, could there be a reason for this?

Answers Wild Nadezhda Ivanovna:

You need an examination of the cervix in the speculum, an ultrasound of the cervix - perhaps there is a threat of premature birth or there is erosion of the cervix, there may be other reasons, but an examination is needed. You may need to do an ultrasound of your kidneys to rule out urolithiasis.

During its development, the baby, found in its mother’s tummy, turns over several times. And after 22-23 weeks of pregnancy, the baby, as a rule, assumes a head-down position - and this is the position of the fetus that is considered optimal for subsequent births. The fetal head is the largest part of its body in diameter, and therefore it is with its passage during delivery that the greatest difficulties are associated. After birth will pass the way the baby’s head, the rest of his body “by inertia”, follows almost unnoticeably. If the baby is positioned vertically in the mother’s tummy, that is, head down, in most cases this position does not bring any difficulties. But it also happens that the fetus takes up space in the womb transverse position: legs or buttocks down. In this case, we are talking about breech presentation during pregnancy, which is diagnosed, as a rule, by the 28th week during the next visit to the antenatal clinic. It should also be mentioned that breech presentation discovered at this time will not necessarily persist until delivery - the baby can change position up to 36 weeks. In addition, there are a number of measures that can help “turn over” the fetus, thereby giving it a cephalic position.

Causes of breech presentation of the fetus

Breech presentation of the fetus during pregnancy can be caused by several factors. Doctors call one of the main reasons a decrease in the tone and excitability of the uterus. Also called causes of breech presentation are abnormalities in the development of the uterus, placenta previa, and some fetal malformations. Breech presentation can be breech, leg, mixed, knee - each of them can be easily diagnosed by a doctor during a routine examination, after which ultrasound confirmation will be necessary. Breech presentation is considered not a completely normal position for both the baby and the mother - although it does not pose any direct major threats.

Though natural childbirth with a breech presentation of the fetus, they are possible, but still, cesarean section is often the indication for delivery. If childbirth proceeds and naturally However, constant and intensive monitoring by a doctor is necessary - births from breech presentation are much more often accompanied by complications.

Signs of breech presentation of the fetus

Physically, if the fetus is breech, the woman does not feel this pathology in any way. She's not bothered by anything pain symptoms or feelings of discomfort, which can clearly signal the “wrong” position of the baby in the uterus.

Breech presentation can only be determined through examination. Thus, with breech presentation, experts note a higher position of the uterine fundus above the pubis, which does not correspond to the gestational age. The fetal heartbeat can be heard more clearly in the area of ​​the navel or slightly above it on the right or left (depending on the position of the fetus).

Also, signs of breech presentation of the fetus reveal themselves during a vaginal examination. For example, when breech the soft volumetric part, the inguinal fold, the coccyx and the sacrum are palpated. With adjacent gluteal and breech position you can identify the baby’s feet with a calcaneal tubercle and short fingers(different from fingers) located on the same line. To clarify the diagnosis, however, ultrasound will also be used.

Exercises for breech presentation of the fetus

You can “give” the baby a head position in the tummy with the help of special gymnastic exercises. They can be used starting from 32-34 weeks of pregnancy - after consultation with your doctor. Gymnastic exercises involve turning the expectant mother in a lying position from one side to the other: 3-4 times approximately every 7-10 minutes. This exercise is performed 2-3 times a day. You can also carry out an exercise that involves lifting the pelvis: lying on your back, you should place some kind of cushion under your lower back (you can use ordinary pillows) so that the pelvis is 20-30 centimeters higher than your head. You need to stay in this position for 5 to 15 minutes, but no more. The exercise is performed 2-3 times a day on an empty stomach. Contraindications for performing such gymnastics are scars on the uterus from any operations, late toxicosis. Offers his methods for breech presentation and Alternative medicine, for example, acupuncture, homeopathy, .

If the above methods did not bring desired results, to the expectant mother may suggest external fetal rotation. This procedure is carried out at approximately 34-37 weeks of pregnancy, always in a hospital setting with monitor, ultrasound monitoring and the use of special drugs that relax the uterus. A successful external revolution will make it possible to subsequently carry out childbirth naturally, but since this procedure is quite difficult, and also has many contraindications (scar on the uterus, obesity, the age of the primigravida is more than 30 years, preeclampsia), it is not suitable for every pregnant woman and is performed quite rare.

Childbirth with breech presentation

If breech presentation could not be eliminated by any of the methods, this should not become a reason for frustration. In this case, the pregnant woman will be advised to go to the obstetric hospital earlier: here after all necessary examinations the method of delivery will be chosen.

Without any serious contraindications, childbirth can occur naturally - under the constant supervision of a doctor. If it is not possible, a caesarean section will be required. Indications for caesarean section in breech presentation are (more than 3.5 kilograms), the presence of a scar on the uterus, narrow pelvis in a pregnant woman, placenta previa, presentation in the foot or mixed position.

Especially for- Tatyana Argamakova

When a pregnant woman finds out that the baby in her tummy is positioned with her buttocks or legs down, she begins to worry because this is wrong. Breech presentation of the fetus is usually diagnosed by the 32nd week of pregnancy during the next visit to the antenatal clinic. But this position does not always remain until childbirth, because the child is able to change its position. In addition, there are a number of measures thanks to which you can “turn over” the fruit, giving it correct position.

What is breech presentation of the fetus?

The fetus in a breech position is located head up in the uterus. It turns out that the baby’s pelvis is located from below, and this is not standard for natural childbirth. Such births occur in 3–5% of cases and are pathological, since the baby may be injured or complications may occur. This diagnosis is made after 32 weeks of pregnancy. The baby in the mother’s tummy floats freely and can turn over several times.

Classification of breech presentation of the fetus

Baby in the uterine cavity may have the following location:

• Leg - the hips, one or both, are extended, and one leg is located at the exit of the uterus. This arrangement occurs in pregnant women in 10–30% of cases.
• Gluteal – the child’s legs are bent in hip joints and pressed to the tummy. This presentation is observed in 50–70% of women.
• Mixed (gluteal-leg) – hips and knees are bent. A similar situation occurs in 5–10% of cases.

Although with this arrangement it is possible to give birth naturally, it is still often shown. If such births occur, they require constant and intensive monitoring by a doctor, because complications may arise.

Causes

Usually, until 31–32 weeks of pregnancy, there is plenty of room in the uterine cavity for fetal movement. As the baby grows, it usually takes a head-down position. Breech presentation of the fetus at 32 weeks of pregnancy occurs in 25% of cases, and closer to childbirth it decreases to three percent. Therefore, if they happen premature birth, then there is a high probability of the child’s incorrect position.

Breech presentation of the fetus is caused by several factors. The main reasons are uterine excitability and decreased tone. In addition, this situation is facilitated by:

• abnormalities of the uterus;
• some fetal malformations;
• presence of multiple pregnancy;
• oligohydramnios or polyhydramnios;
• placenta previa.

Signs

Physically, a pregnant woman does not feel this pathology in any way. She is not bothered by discomfort or pain, which may warn of an incorrect position of the baby in the uterus. This situation is determined only during examination. At the same time, the baby’s heartbeat in the navel area can be heard much more clearly.

Such signs are detected during a vaginal examination. For example, when breech position the doctor palpates the inguinal fold, the soft volumetric part, the sacrum and the coccyx. With a mixed foot and buttock position, the child’s feet are determined with a heel tubercle and toes that are located on the same line. To clarify the diagnosis, an ultrasound scan is required.

A baby in the breech position can be born naturally or by caesarean section.

Choosing a method of delivery depends on factors such as:

Childbirth at pelvic location a child can be natural if:

• pregnancy period is more than 37 weeks;
• average fruit weight – 2500 – 3500 g;
• the pelvis is of normal size;
• the unborn child is a girl
• presentation is breech or gluteal-foot.

In all other cases, surgery is required. Sometimes, during a natural birth, the doctor decides to perform a caesarean section, which called emergency. Indications for immediate surgery are:

• loss of the baby's arms or legs, as well as the umbilical cord;
• placental abruption;
• weak labor activity;
• fetal hypoxia.

Possible complications

Breech presentation of the fetus does not affect the course of pregnancy at all, but during childbirth there may be serious complications.

Firstly, it may be weak labor. This condition occurs due to the fact that the pelvic end is much smaller in volume than the head and puts less pressure on the uterus, which begins to contract worse.

Secondly, during childbirth, the baby's head may tilt back, and it is difficult for it to come out. There is a high risk of injury to the child.

Thirdly, with a breech presentation, the umbilical cord is usually clamped between the head and the wall of the birth canal. This leads to obstruction of oxygen flow, causing hypoxia in the fetus.

Fourthly, during childbirth, the arms may be thrown back, which can lead to injury.

How to correct abnormal fetal position?

Many pregnant women start to panic very early when they find out that their baby is not positioned correctly in the tummy. Ultrasound at 21 or 22 weeks pregnancy usually already shows what position the fetus has taken and if it is pelvic, then women begin to look for methods that would correct this condition. But it’s too early to think about this. But if the ultrasound at 32 weeks showed incorrect position fetus, it is recommended to perform special exercises. Thanks to them, in most cases the child takes the head position.

Exercises should be performed from the 32nd week of pregnancy, but only if it proceeds without complications, otherwise you can harm the baby. All classes should begin with a warm-up. The woman should walk at a normal pace for several minutes, after which she should walk on her heels and toes. The arms can be rotated, raised and lowered, and the knees can be raised to the side of the abdomen. Below are simple exercises which are recommended to be performed after 32 weeks of pregnancy if the baby is breech.

Exercise 1

You need to stand up, straighten your back and spread your legs. Your arms should hang freely along your body. Need to stand on your toes, spread your arms to the sides, arch your back and inhale. Then you should exhale and get back to the starting position. This exercise must be performed 4 to 5 times.

Exercise 2

In this case, you will need pillows that will be used to elevate the pelvis. A pregnant woman should lie on the floor and place pillows under her pelvis, which should rise 30–40 cm above shoulder level. Shoulders, knees and pelvis should form a straight line. It is recommended to perform this activity twice a day for five to ten minutes on an empty stomach.

Exercise 3

You should lie on your back, bend your legs and spread them shoulder-width apart. Your feet should rest on the floor. Relaxed arms are extended along the body. Then you need to take a breath, lift your back and pelvis, and when exhaling you need to take the starting position. After this, straighten the legs, take a breath, drawing in the stomach. The muscles of the buttocks and perineum should be tense. When exhaling, return to the starting position. It is recommended to perform this exercise 6 – 7 times.

Except physical exercise, the position of the fetus can be affected by walks in the fresh air and proper nutrition. Pregnant women should sit in chairs with a firm back and a hard seat. If you have to sit on upholstered furniture, you should spread your legs slightly so that your stomach rests freely. You can also buy a fitball to perform special exercises on it that can change the breech presentation of the fetus.

Ultrasound and medications

If such methods do not bring the desired result, then the doctor may offer the woman in position ultrasound procedure and drug intervention. It is recommended to carry it out no earlier than 34 weeks of pregnancy using special medicines. This procedure is quite complex, but very effective, after which a woman has the opportunity to give birth naturally.

This procedure has contraindications:

• obesity;
• entanglement of the fetus with the umbilical cord;
• gestosis;
• scars on the uterus;
• the age of the first-time mother is more than 30 years, etc.

This method is not suitable for everyone during pregnancy, so it is used quite rarely in obstetrics and gynecology.

Thus, you should not panic when you learn that the baby is in a breech position. Before giving birth, he will be able to change his position several more times. From 32 weeks you can perform special exercises, but only in the absence of contraindications. If the baby continues to be in a breech position, the doctor will select best option delivery.

The reasons can be divided into two groups - depending on the mother and on the fetus itself.

The first group of reasons for this diagnosis includes:

• Polyhydramnios
• Low water
• Umbilical cord entanglement
• Carrying several children at the same time
• Uterine fibroids, decreased tone and ability to contract
• The umbilical cord is not long enough
• Placenta previa
• Narrow pelvis or deformation of its bones.

The second group of reasons include:

• The intrauterine development of the fetus is disturbed, its delay can be traced, the child is small in size, which contributes to its free movement
• Prematurity
• Developmental defects.

It should be remembered that up to 32 weeks the baby can repeatedly occupy different positions. After this period, this is not so easy for him, since he is growing rapidly, and the space in the uterus is becoming less and less. Therefore, if by 32 weeks the baby has not turned head down, then breech presentation is confirmed.

Problem Definition

What does breech presentation mean? Answer this question yourself future mom cannot, in the same way, identify this problem. After all, she does not feel any changes in her condition, she is not bothered by discharge or other signs that something is wrong with the baby.

The doctor can determine the incorrect position of the child by conducting a vaginal examination and palpating the fetus.

ABOUT existing problem can be judged by the fact that:

• Measurements of standing above the pubis of the uterine fundus do not coincide with the gestational age. They are somewhat taller;
• The heartbeat can be heard in the area of ​​the pregnant woman’s navel; it is quite distinct;
• When examining the vagina, the baby’s feet (legs, funny) or the tailbone, sacrum (gluteal) are palpated.

Based on these indicators, the doctor sends the woman for an ultrasound, based on the results of which a final diagnosis is established.

Delivery with abnormal fetal position

With a breech presentation of the fetus, natural childbirth is not excluded. To do this, the doctor assesses the condition of the pregnant woman and the fetus, and gives permission for this if:

• The woman is 37 weeks pregnant;
• The child weighs no less than 2.5 and no more than 3.5 kilograms;
• The woman’s pelvis is not narrow, there is no deformation of the pelvic bones;
• Leg presentation was not detected;
• A girl is expected to be born.

In this case, the woman can give birth naturally. The mechanism of childbirth is divided into 3 stages:

Stage 1. Contractions

• When they begin, the expectant mother should take a horizontal position. If possible, lower limbs and the pelvis should be slightly higher than the upper body. Maximum comfortable and safe posture during this period - this is the position on the side where the baby’s back is located;
• After the water breaks, a vaginal examination is performed. Thanks to this, it is determined whether there are indications for an emergency cesarean section (it is performed when the umbilical cord or legs fall out);
• Labor activity is monitored by CTG, Special attention is given to the uterus – its contractile activity is monitored;
• To avoid hypoxia, its prevention is carried out;
• In some cases, pain relief may be needed. Anesthesia is then applied;
• Additionally, antispasmodics can be used when the dilatation of the cervix has reached 4 centimeters.

Second phase

• In order to avoid weakening of contractions, Oxytocin is administered;
• The baby’s heartbeat, intensity and course of contractions are monitored;
• The perineum is cut at the moment when doctors record the eruption of the child’s buttocks;
• When eruption of the buttocks has occurred or the lower limbs have appeared, depending on the situation, the doctor may use manual assistance. This is done in order to help the baby be born with minimal consequences for him and the woman in labor.

Third stage

If the previous periods proceeded without complications, then the third proceeds in exactly the same way as during normal childbirth.
The doctor prescribes a caesarean section for breech presentation if:

• There is a risk premature appearance baby into the world;
• The baby's weight does not reach 2.5 or exceed 3.5 kilograms;
• The birth of a boy is expected;
• Leg presentation was determined;
• Hyperextension of the head was detected.

When a woman has no indication for a cesarean section, and the doctor allows her to give birth naturally, prerequisites for an emergency cesarean section may arise:

• Insufficient oxygen supply to the fetus;
• Weakening labor activity;
• Abrupt placenta;
• Prolapsed umbilical cord or lower, upper limbs;
• Non dilating cervix.

What complications can you encounter?

As already mentioned, this position of the baby does not affect the course of pregnancy, which cannot be said about the birth itself. Their course may be complicated due to certain factors:

• The pelvic part of the fetus is inferior in volume to the head. The pressure of the pelvic part on the uterus is too weak, and therefore its opening occurs too slowly. And the result is weak labor activity;
• The baby's head may be in the wrong position. When tilting it back there is big risk getting injured;
• Oxygen may not reach the baby in sufficient quantities. The cause of hypoxia is the umbilical cord sandwiched between the head and the wall of the birth canal;
• The fetal arms may tip back, causing birth injuries.

How to fix the situation

The natural desire of pregnant women who learn about this diagnosis is to do everything possible to solve the problem. In this case, it is important to remember that breech presentation of the fetus at 20 weeks is not yet an indicator. At this time, the baby can take different positions. Therefore, at this stage, panic should be postponed, paying attention to your health, proper nutrition and good rest.
We can talk about the reliability of the diagnosis starting from 30–32 weeks. If the situation has not changed by this time, then most likely the baby will no longer turn head down. But there is a chance for the situation to change. Moreover, experts have developed special exercises for turning the fetus during breech presentation.

Before you begin performing a set of exercises in mandatory You should visit a doctor and discuss this issue with him. This is necessary in order to make sure that there are no contraindications for this, and that the baby will not be harmed. After all, pregnancy proceeds differently for everyone, and due to the characteristics of the expectant mother’s body, any physical activities she may be banned.

What to do? Many pregnant women who are faced with this problem are helped by a complex consisting of 4 exercises. Before you start doing them, you need to prepare your body and warm up your muscles. To do this, just walk for a few minutes at a calm pace, alternating it with walking on your toes and heels. It wouldn’t hurt to warm up your arms (circular rotations, warming up your hands, elbow bend, fingers) and legs (raising your knees slightly to the side of your stomach).

Exercises for breech presentation:

1. We stand straight, legs slightly apart, back straight. Carefully, slowly, we stand on our toes, spreading our arms to the sides. We hold this position for a few seconds, arching our back. We lower ourselves onto our entire foot. We do this 5 times.
2. Lying on a flat surface, place a pillow under the pelvis, bend your legs at the knees. You need to ensure that your shoulders are below your pelvis by at least 30 and maximum 45 centimeters. We lie in this position for 5 to 10 minutes. This exercise is best done before meals. 2-3 repetitions per day are enough.
3. We get down to the floor, get on all fours, neck relaxed. Inhale and at the same time round your back, pointing your chin towards your chest. Exhaling, we try to bend as much as possible in the lumbar region, moving our head back. Repeat 5 times.
4. We lie down on the floor, bend our legs at the knees, and focus on our feet. The arms are relaxed, straight, located along the body. When we inhale, we try to lift the stomach and pelvis as much as possible, resting our feet and shoulders on the floor. We return to the starting position as we exhale, then straighten our legs, inhale, and draw in our stomach. When exhaling, we relax the muscles. We perform the exercise 7 times.

There is no need to panic when breech presentation is confirmed. Finding herself in this situation, a woman should think positively and set herself up for the best. She needs to trust her doctor as much as possible, who will select the best option for childbirth, monitor its course, and prevent all kinds of complications.
In addition, the expectant mother should remember that she is able to contribute normal flow childbirth

She needs to heed the following advice:

• Eat right and regularly walk in the fresh air;
• Perform the exercises given above after consulting a doctor;
• Try not to sit on upholstered furniture. If there is no other option, then your legs should be spread apart when sitting;
• It is recommended to replace soft sofas and armchairs with chairs with hard backs. At the same time, you need to keep your back straight;
• Buy a fitball. There are many exercises that can help you prepare for childbirth and help your baby take the correct position;
• Don't wear a bandage. Despite the fact that this thing is beneficial for pregnant women, as it supports the abdomen and distributes the load, in the case of a breech presentation, its use should be abandoned. After all, the possibility that the fetus will turn over and take the correct position cannot be discarded. And the bandage prevents him from moving.

And do not forget that before 32 weeks the problem can resolve itself. If this does not happen, then you can begin to perform special exercises. But you shouldn’t despair, because many women have successfully given birth healthy children with breech presentation of the fetus. Therefore, before childbirth there should only be positive emotions and an optimistic attitude. After all, the child feels the mother’s mood.

Video exercises

More recently, a special breech presentation of a child was not considered a serious pathology in obstetric practice. But today the opinion of experts regarding this issue has changed. This is due to the likelihood of complications of labor and a fairly large percentage of congenital abnormalities in the development of the baby.

Definition and types

Compliant with the norm longitudinal position The fetus is diagnosed at 25 weeks of pregnancy. Compared with the rest of the body, the baby's head at the time of birth has largest diameter. Therefore, doctors associate the greatest difficulties with its passage during childbirth.

There are times when the baby takes mother's womb not vertical, but transverse position: his buttocks or legs are lowered down, which is most often diagnosed at 26 weeks of pregnancy.

The following types of pelvic position of the baby are distinguished:

1. The breech position is the most common type, in which the baby’s buttocks are adjacent to the entrance, the legs are bent to the tummy, the baby’s head and arms are pressed tightly to the chest.
2. Mixed or heterogeneous position, a characteristic of such a presentation: the baby’s buttocks and feet are adjacent to the entrance.
3. Leg position – in which the feet of both legs or one leg are adjacent to the entrance.
4. Kneeling position - the baby in the womb seems to be on its knees. This species is noted in medical practice quite rare.

Throughout pregnancy, the baby constantly turns over and thereby changes its position. As a result vertical position the fetus may change at week 20, and at week 29 the doctor will discover pelvic position. Conversely, with a breech presentation of the fetus at 20 weeks, it is difficult to make a final conclusion that this position will remain until the birth process begins.

Causes

Every woman in labor should know the dangers of breech presentation of the fetus. Indeed, during the process of childbirth, sudden serious complications can arise that adversely affect the health of the baby and his mother. These include: baby suffocation, ruptures birth canal in the mother, spinal injury or intracranial injury in the infant. In order to avoid undesirable consequences, you need to try to help the baby with a breech presentation at 35 weeks of pregnancy change his position.

Causes of breech presentation of the fetus:

• decreased uterine tone;
• various anomalies of the female reproductive organs discovered during diagnosis;
• excessive and insufficient accumulation of amniotic fluid;
• specific deviations in child development;
• features of the placenta.

Most often, with a breech presentation of the fetus at 37 weeks of pregnancy, a cesarean section is indicated. But sometimes natural childbirth is possible, requiring minute-by-minute monitoring by a doctor.

Signs

The expectant mother does not feel the particularly unusual position of the baby in her womb. With a breech presentation of the fetus during pregnancy, the pregnant woman does not experience any pain or other discomfort. But this fact cannot mean that the problem does not exist at all.

Signs of breech presentation:

• At 34 weeks of pregnancy, there is a more noticeable protrusion of the uterus above the pubis.
• With a breech presentation of the fetus at 30 weeks, the baby’s heartbeat can be heard more clearly at the mother’s navel, as well as slightly to the left or right of it.
• With a breech presentation of the fetus at 33 weeks, an unusual position of the child is felt when examining the vagina: his tailbone is palpated in a diagnosed breech presentation, the tubercle of the heel and smaller fingers (not as long as on the arms) in the foot position.

Special gymnastics

In practice, if a breech presentation of the fetus is diagnosed at 21 weeks of pregnancy, this position of the child is not necessarily maintained until birth. For example, a change in fetal position may be observed at 34 weeks. Breech presentation of the fetus at 32 weeks can be changed by doing the necessary gymnastic elements.

Recommended gymnastics for breech presentation of the fetus includes the following actions:

1. The breech presentation of the fetus at 31 weeks can be changed if the pregnant woman makes 10 turns or rolls in a supine position from one side to the other. You need to do the exercise three times a day.
2. At 31 weeks of pregnancy, a woman is recommended to perform this simple task: lying on her back, place a small pillow under her lower back. The back should be raised by approximately 20–30 cm. Remain in the given position for 3 to 12 minutes. Perform the exercise three times a day on an empty stomach.

A woman can begin performing these exercises with a breech presentation of the fetus from 31–34 weeks after the permission of the attending physician. Possible contraindications there may be scars on the uterus after undergoing surgical interventions, special position placenta, toxicosis in late stages.

Other ways to change position

In addition to special gymnastics, the expectant mother can wear a bandage, which can also affect the change in the position of the baby in the womb. In addition, there is an opinion that with this pathology it is useful to sleep on the left side.

If exercises don't bring meaningful result and the longitudinal position of the fetus is not diagnosed, the attending physician may recommend a specially developed procedure for external rotation of the baby. It can be carried out under ultrasound monitoring of the fetus at 36 weeks. hospital conditions. During the procedure, special substances are used to relax the uterine tone.