About 3% of expectant mothers may find that they are in breech position when they are nine months pregnant, which is generally called fetal sitting, because fetal sitting may cause difficulty in delivering the fetus, cause birth trauma to the mother, and the fetus may be deformed. There may be fibroids or deformities; so once you find that the fetal position is incorrect, you must discuss with your doctor which delivery method is best.
The incidence of abnormal fetal positioning varies at different weeks of pregnancy. For example, at the fifth month of pregnancy, about 33% of the fetuses were abnormally positioned, while at the eighth month of pregnancy, only about 8.8% were abnormally positioned, and at the ninth month of pregnancy, only about 5% were abnormally positioned. normal. Misalignment, that is, about 90% of misalignments will automatically turn into a normal head-down position.
1. How to deal with abnormal fetal position
In terms of obstetric treatment, the diagnosis is confirmed when the fetal position is still abnormal at nine months (36 weeks), but there are still a very small number of multiparous women who still have the opportunity to change the fetal position before delivery. At 32-34 weeks, when the fetal position is still breech, a decision should be made to (1) implement artificial fetal position externalization method; (2) natural breech delivery; (3) direct caesarean section.
When artificial external rotation is performed, medications are usually given to relax the uterus. When performed by an experienced doctor, the success rate is approximately 60%. However, external rotation is not recommended for pregnant women with a history of caesarean section. In addition, the amount of amniotic fluid must be moderate, the fetus\’s back must be on both sides, the mother\’s weight must be moderate, and the fetus\’ buttocks must not penetrate deep into the pelvis before external rotation is appropriate.
2. Precautions for vaginal delivery
When external rotation fails or is not suitable for pregnant women with abnormal fetal position, when choosing vaginal delivery, you must pay attention to X-ray or computed tomography to determine whether the pelvis is sufficient to pass. At the same time, the weight of the fetus must be between 2500-3500 grams. extend. Since the buttocks are usually smaller than the head, the descent may be faster, but the head cannot be delivered easily. Consider having a premature delivery time to avoid birth trauma or cranial crisis and ultimately be able to give birth. If prolonged labor occurs, an early caesarean section is required.
In addition, the fetal position with one leg or both legs upright is not suitable for vaginal delivery. Otherwise, the umbilical cord will fall off prematurely, causing a crisis of fetal hypoxia that is much greater than in a normal fetal position. This abnormal fetal position must be paid attention to at all times. When the amniotic membranes rupture, a vaginal examination should be performed to determine whether the umbilical cord is prolapsed.
In recent years, younger doctors have had little experience performing breech vaginal deliveries. A senior doctor must be present to assist in the delivery to ensure the safety of the fetus. At the same time, the breech forceps must also be prepared for use.
Improper breech vaginal delivery has the following risks: (1) Hypoxia during delivery; (2) Cerebral hemorrhage; (3) Spinal injury; (4) Hand nerve injury; (5) Fracture; (6) Visceral injury (7) Oral cavity , throat injury, etc.
3. Most mothers choose caesarean section
In the past ten years, breech delivery in major hospitals has gradually been replaced by caesarean section.Because many studies have found that caesarean section fetal safety is higher than the uncertainty of vaginal delivery. It\’s not all about the doctors. Under the concern of the pregnant woman and her family for the fetus and the requirement of zero mistakes, the doctor and the pregnant woman jointly chose a caesarean section. However, in the current environment, I personally think that for pregnant women who have not had a cesarean section after their second pregnancy, if the fetus is not large and the pregnant woman has no complications, breech presentation is a pure breech presentation without straight legs. Under normal circumstances, it can still be considered Vaginal delivery, but it is best to discuss the pros and cons with your primary care physician before making a decision.
4. in conclusion
Due to the above-mentioned risks during vaginal delivery, expectant mothers with abnormal fetal position can choose in vitro transfer or cesarean section. However, cesarean section is not completely safe, and complications such as blood loss and wound infection may occur. When a mother discovers an abnormal fetal position, she must handle it carefully and consult with experts in order to deal with the challenge safely.