Abnormal fetal position

Introduction Abnormal fetal position generally refers to the position of the fetus in the uterus after 30 weeks of pregnancy, and the longer seen in the pregnant woman and the maternal woman with loose abdominal wall. Abnormal fetal position includes breech position, transverse position, posterior occipital position, and facial position. More common in the breech position, and the horizontal position harms the mother and baby. Because abnormal fetal position will bring different degrees of difficulty and danger to childbirth, early correction of fetal position is of great significance for the prevention of dystocia. The position of the fetus in the uterus is called the fetal position. The normal fetal position should be the longitudinal axis of the carcass parallel to the longitudinal axis of the mother, the fetal head at the entrance of the pelvis, and the flexion, the ankle is close to the chest wall, the spine is slightly curved, the limbs are flexed and crossed before the chest and abdomen, and the entire carcass is oval. , called the front position of the pillow. In addition, the remaining fetal positions are abnormal fetal positions.

Cause

The causes of malposition are uterine dysplasia, uterine malformation, pelvic stenosis, pelvic tumor, fetal malformation, and polyhydramnios. Abnormal fetal position can cause dystocia during childbirth, and more surgery is needed. Improper handling can even endanger the lives of mothers and fetuses. The traditional Chinese medicine perspective is mainly qi and blood weakness and qi stagnation and blood stasis. It can be seen that the pregnant woman is weak and has insufficient vitality. The god is weak and weak and unable to promote the child to turn positive, or because of excessive comfort, or feel cold evil, cold blood stasis, gas is not Running, blood is not smooth, qi stagnation and blood stasis, but also because of pregnancy panic and anger, liver qi stagnation, air dysfunction, and the fetal position is not correct.

an examination

Related inspection

Obstetric B-ultrasound

1. After 28 weeks of gestation, the abdominal position was confirmed by abdominal, vaginal and B-ultrasound examination.

2. Diarrhea diagnosis: Abdominal examination of the uterus is a vertical ellipse, the bottom of the uterus can touch the round and hard, pressing the fetal head with a floating ball. A soft, wide and irregular fetal hip can be seen above the pubic symphysis. The fetal heart sounds are most clearly heard on the left or right side of the umbilicus. B-ultrasound inspection of the fetal head under the costal margin. Above the pubic symphysis is the arm or the foot.

3. Diagnosis of the transverse position: The uterus is a horizontal ellipse, the fetal head is touched on the side of the mother's abdomen, and the pubic symphysis is relatively empty. The fetal heart sounds are most clearly on both sides of the umbilical cord. B-ultrasound examines the fetal head on one side of the mother's abdomen.

Differential diagnosis

The diagnosis should be differentiated from the following symptoms:

1. The fetal position is not correct: the correct order of normal output should be first from the head. If the lower body is produced first, even the shoulders, arms and other parts are first produced, which is called "the fetal position is not correct". The most common is the so-called breech position, that is, the direction of the buttocks toward the cervix and the birth canal. Others such as oblique or transverse position (shoulders or trunks facing the birth canal) are less, but the risk is not small. This is only the most rough classification. In fact, only the first child in the back of the head is the easiest way to produce, and other methods are likely to cause more or less danger or prolonged labor during the production process.

2. Incomplete breech presentation: Incomplete breech presentation with one foot or two feet, one knee or two knees or one foot and one knee. The first exposure of the knee is temporary, and the beginning of the birth process turns to the first exposure. Less common.

3. Hip production: Normal pregnancy is close to full-term production, most of the fetus's position is head-down, this so-called "head-type" accounted for 96%, while 3% is ass down, It is called "hip-type".

4. Fetus single arm first exposed: single hip first exposed or straight hip first exposed (frank breech presentation) fetal double hip flexion, knee joint straight extension, with the hip as the first exposed. Most seen. The breech presentation is the most common abnormal fetal position, accounting for about 3% to 4% of the total number of full-term deliveries in pregnancy. Because the fetal head is larger than the fetal buttocks, and there is no obvious deformation of the fetal head after delivery, it is often difficult to deliver, and the umbilical cord prolapse is more common, which increases the perinatal mortality, which is 3 to 8 times that of the pillow. The breech presentation is based on the tibia, and there are six types of fetal positions: the left front, the left left, the left, the right front, the right, and the right.

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