Breech presentation usually guards and a woman, and an obstetrician-gynecologist who is watching her. Therefore, often waiting until the end of pregnancy, the baby will turn and take the correct position or trying to help him turn over. If this does not happen, then there is no tragedy in this, simply by taking a birth fetal position will be considered.

Fetal presentation

Presentation of the fetus is determined by the nature of the presenting part, ie the part of the fetus, which is directly above the entrance to the pelvis. When the correct position of the fetus presentation can be either the head or pelvis. The options are occipital cephalic presentation (in most cases), perednegolovnoe, frontal and facial. The options are breech breech, buttock-Foot (complete or incomplete) and foot (complete or incomplete).

If the wrong position of the fetus presenting part is not, it may occur during childbirth, when the entrance to the basin is suitable shoulder of the fetus or a side handle drops and so on.

Breech presentation, options and reasons

In the first half of pregnancy, the baby is usually head up and down the buttocks, about the 32nd week of pregnancy, there is a revolution - the child is turned head down. But some children (3-4%) are not rotated. This baby's legs can be bent only in the hips and stretched along the body (purely breech presentation) or in the hip and knee joints (mixed breech presentation).

The reason that the child can not turn over upside down, often narrowing and irregular shape of the pelvis, malformations of the uterus, uterine fibroids, congenital malformations of the fetus, placenta previa, violation of uterine tone due to the large number of births, the location in the uterus several fruits, supermotility fetal polyhydramnios and so on.

With breech presentation is usually marked by high standing uterus, when probing head is on top, and buttocks - the bottom. Breech presentation is well determined by ultrasound.

Flip fetus

In some cases, the fetus can turn upside down just before birth. But sometimes this change helps him carry out an obstetrician-gynecologist with the help of external cephalic for turning breech in the head. For this turn from a doctor is required experience and excellent knowledge of this technique, since the rotation is not secure.

Complications that may arise in the course of external rotation of the fetus - it's premature birth, placental abruption, cord compression or wound around the neck of the fetus. In view of the rather severe complications such upheaval is rare, but expanding the indications for cesarean section, as statistically confirmed that the operation a child who is in the breech position, injured less.

How is natural childbirth when breech delivery

When natural childbirth every movement of the fetus taken to relate to the next plane of the pelvis: the entrance to the basin, the wide and narrow parts of the pelvic cavity, leaving the pelvis. The fetus begins to move through the birth canal under the action of intrauterine pressure, contraction of the muscles of the pelvic floor muscles and the resistance of certain parts of the fruit.

First, the buttocks of the fetus moving from wide to narrow pelvis (the fruit is rotated so that the transverse dimension of the buttocks coincided with the direct size of the pelvis). First out front buttock, then there is flexion of the lumbar part of the fruit, which contributes to the output of the rear buttocks. The next point - the establishment of a coat hanger in the forward rate of exit from the pelvis, and the back goes to the side and front shoulder comes out of the pelvis, the spine bends and allows the shoulder to go back. Then head rotates anterior neck, bends, turns and again is born: first the chin, and then mouth, nose, crown and nape.

Help in childbirth giving birth to breech presentation

During the opening of the birth canal must be conducted prevent premature rupture of the membranes, so giving birth is assigned bed rest. Home obstetric care during the period of the expulsion of the fetus is to prevent compression of the umbilical cord after birth, lower body, which turned the baby's body, repeating its natural motion and preventing the possible obstacles in his path.

During childbirth may occur following complications: delayed rupture of membranes, various anomalies (irregularities) of labor, drawing back the handles, prolapsed cord or small parts of the fruit, a spasm of muscles of the uterus in place of an exit of the fetus from the compression of the torso or the neck of the fetus, and various soft tissue injuries, brain and spinal cord fetal asphyxia (lack of air) of the fetus.

In order to correct all these complications developed special techniques, in addition, if the life of a woman or child in danger, then held caesarean section - dissection of the anterior abdominal wall and the wall of the uterus with extraction of the fetus.

Caesarean section is performed in cases where the woman does not want to risk (for example, she had been waiting for this child, or she had a stillbirth, etc.) or it is suffering some gynecological diseases, such as uterine cancer Uterine fibroids - when surgery is needed? It has a narrow pelvis. The indications for cesarean section may be toxicosis second half of pregnancy, prolonged pregnancy, first child over the age of 30 years, a large fetus, placenta previa, and so on.

Prevention of breech presentation is a special physiotherapy, which is held throughout the pregnancy up to 35 weeks.

  Galina Romanenko

The number dialed during pregnancy weight depends on many different factors - diet, physical activity, weight before pregnancy. Experts believe that women with normal weight before pregnancy (with a body mass index up to twenty-five) for the entire period of pregnancy can dial eleven to fifteen kilograms.

If pre-pregnancy weight was below normal women (body mass index less than eighteen and a half), then for optimal pregnancy weight gain is twelve to twenty kilograms, depending on the height, physique and health status of women. If pre-pregnancy weight, on the contrary, higher than normal (BMI twenty-five - twenty nine), that during pregnancy a woman needs to monitor the weight of a little more - in this case, the optimal weight gain is considered to be a seven-eleven kilograms.

"Healthy" weight gain during pregnancy is absolutely natural and even necessary for the normal health of the mother and child. However, it is not necessary to believe that it is necessary to use without restrictions harmful high calorie fatty foods, get closer to the "normal" performance - individual deviations from the norm are quite natural. It is very important a balanced, proper diet Proper nutrition - the basic precepts of healthy food And limit yourself in calories is not necessary. Moreover, as recommended by gynecologists and pediatricians, during pregnancy a woman of normal weight, exercise is paid Myths about exercise: do not believe   less than thirty minutes per week, in the first trimester should be consumed daily eighteen hundred calories during the second trimester - two thousand two hundred calories in the third trimester - two thousand four hundred calories. The sources of calories should serve whole grains and dairy products, proteins, fruits, vegetables, healthy fats and oils.

What determines the weight gain

• Three and a half kilograms on average weighs child at the end of pregnancy
• Approximately seven hundred grams - the weight of the placenta
• One and a half to two kilograms of body weight is due to increased volume of fluid
• Nine grams - kilograms - the weight of the uterus
• Another kilogram - the total weight of the breast
• One and a half to two kilograms - an increase in the total volume of blood
• Three kilograms - reserves of fat, protein and other nutrients necessary for normal development of the child during pregnancy
• One kilogram - amniotic fluid (amniotic fluid)

Thus, twelve or thirteen kilos accumulated during pregnancy - it is natural and even necessary weight gain.

The rate of weight gain is primarily dependent on the stage of pregnancy. During the first trimester of a woman with a normal prenatal weight gain an average of one to two kilograms. In the second and third trimester each week increases the weight by five hundred grams - kilogram.