Breech presentation of the fetus often uneventful. However, breech presentation is considered to be more dangerous in terms of injury to the mother and fetus. That is why the management of labor breech fetus developed special techniques.

What is breech

Breech - is intrauterine fetal position in which his pelvic area predlezhit the entrance to the mother's pelvis. The frequency of breech presentation varies from 2, 7 to 5, 4%.

Breech include gluteal (flexion) and leg (extensor) previa. Breech presentation is divided into:

• purely gluteal (partial) previa, where the entrance to the pelvis facing the buttocks and legs bent at the hips, pressed against the body and stretched along it;
• Mixed (full) previa, where the entrance to the pelvis predlezhat buttocks with feet legs, bent at the hip and knee joints.

Foot previa divided into complete, at which predlezhat both legs incomplete (predlezhit one leg) and knee with previa fetal knees.

How are breech presentation of the fetus

It depends on how many years the woman as a real pregnancy proceeded as far as the woman's body is ready to leave, not too narrow pelvis, and whether it is the size of the fetal head, fetal bladder condition, the type of breech and other moments.

With a good indicator of readiness of women for childbirth and its condition genera usually occur naturally. The first stage of labor in breech presentation differs from the similar period in the cephalic presentation so that the head comes last. As a result of the birth canal expanded enough and are poorly prepared for the birth, which can cause a number of complications: tilting handles, delayed head pressed against the umbilical cord. All this leads to delays in delivery and hypoxia (oxygen starvation) of the fetus, which is dangerous for its brain.

Often, while there is premature discharge of water. To prevent this complication, a woman in labor should comply with bed rest. During labor you need to continuously monitor the heartbeat of the fetus. For the prevention of fetal hypoxia woman administered special drugs. In case of violation of labor indicated caesarean section.

In the second stage of labor (the period of the expulsion of the fetus), sometimes it is necessary to carry out the dissection of tissues of the birth canal for the passage of the fetal head (perineotomy or episiotomy).

There are special hand aids that are used during labor and delivery breech fetus. The most famous of them - manual and manual on Tsovyanovu classical manual grant.

Manual benefit Tsovyanovu

When pure essence of breech presentation aids is to maintain the normal position of the legs of the fetus (hip flexion and extension in the knee joint). To do this, after the birth of buttocks, facing front, an obstetrician covers thumbs and hip fetus as the birth of the fetus gently presses his legs to the tummy, which prevents loss of the legs of the fetus and for the drawing back of the head handles.

After the birth of the fetus to the blades during the rotary motion of the fetus done carefully removing the anterior shoulder first, then the rest of the series output of the shoulder girdle. Then he shows the chin and head, they are born they are taken on their own or with special hand-held devices.

Classic Manual Guide

Classic Manual Guide - a complex of measures aimed at the birth of the shoulders and head. The fruit is born to own umbilical ring. After the birth the navel cord is inspected, checked her pulse and the tension. If the tension is strong, it weakened, if that fails, then the umbilical cord cross and try to hold birth as soon as possible.

There are three phases in the provision of classic hand tools:

• The first stage - the passage of the child from the navel to the lower corner of the scapula; the fruit of her hands while covering the hips, torso and lower turn until the birth canal of the lower corner of the scapula;
• the second phase - the release handles - according to the following rules: each handle obstetrician releases of the same name by hand, at the same time turning the body of the child;
• third phase - the release of the head, which must pass through the birth canal in a state of flexion, which is achieved using various techniques.

Breech - it is not a tragedy, in the vast majority of births take place without complications, as there are time-tested methods of their proper management.

Galina Romanenko

  In recent years, women have been increasingly giving birth at home. Those who have had such a positive experience, spoke of him with enthusiasm and encouraged all women to give birth to a "natural" way. Such enthusiasm usually does not happen after the birth in the maternity hospital. So maybe, well them, these hospital - hotbeds of infection, rudeness and lack of professionalism?

Childbirth as a source of danger

First of all, it is necessary to evaluate the real threat that may arise during childbirth, because only then can we properly assess the situation and make your choice.

• Danger of the first and most terrible - the bleeding. Bleeding can occur at any stage of labor, and if sufficiently large vessel bleeding, the woman without surgery can be lost in a few minutes. Predict the bleeding is very difficult. The situation may be complicated by DIC (dissiminiruyuschim intravenous blood clotting), which interferes with the activities of coagulation and anticoagulation systems of blood.
• Risk of second - embolism. Embolism - blockage of a blood vessel is the reason - the gap clot from a vein thrombophlebitis or amniotic fluid. Condition requires instant medical care.
• Danger third - weak labor. He suffers from a child, as in the process of prolonged labor lacks oxygen, the consequences can be very sad, until the Cerebral Palsy. In such cases, the stimulation of labor.
• Danger Four - entanglement umbilical cord fetal neck. During labor, the umbilical cord is pulled, which has a traumatic effect on the child. It requires immediate medical care, perhaps - operation.
• Danger fifth - rupture of the cervix. If time does not sew, there may be bleeding and infection accession.

And this is not all the dangers that lie in wait for the woman in childbirth - more of them.

Assessing labor at home

Births at home with the music, in the presence of her husband - it's great for the mental state of the mother and child. But let's see how this works in practice.

The first point - who help in childbirth. Well, if it really is prepared by a professional. But the true professional is rarely decide to take a home birth, knowing how it would end, and having no legal basis for it. Therefore, there were the so-called "spiritual midwives", who do not bear for their actions any responsibility. Well, if such a "midwife" has a medical degree, but often it is not. So what will he do with complications?

The second point - and whatever they have in the West? In Europe and the US practice of home births, they are legally legalized, take them only by specialists who are responsible for what they do. In most cases, delivery takes an experienced midwife who notice complication and time hospitalizes woman. However, the risk is great, as a midwife (and obstetrician-gynecologist) will not be able to provide certain types of care at home at the time.

The third point - a home birth in the bathtub. This is really dangerous, because very few people know that the water can only be during labor and birth (and even then it can swallow water from the bath). The last period of birth - the birth of the placenta is not compatible with being in the water, as in this period, the lining of the uterus remain gaping blood vessels through which the mother's body can get infected from a bath. In addition, it is possible imperceptible bleeding that often accompanies the birth of the placenta.

We weigh all the "pros" and "cons"

The task of a pregnant woman and her family very carefully examine all the possible consequences of childbirth and to make the correct decision adequate.

Yes, in our maternity hospitals often runs rough rude staff, there is not always ideal conditions. However, there is one distinct advantage: the presence of a professional who is legally responsible for the lives of women and children. Of course, you can cause a lot of bitter examples when professionals do not do their job. But there are others who can help, and help, just when everything ends well, then this is quickly forgotten.

Home births have their positive sides, but in our country they are not "decorated" the relevant laws, so they are mainly engaged in unprofessional and it is often the most tragic consequences. If you do decide to give birth at home with the help of "spiritual midwife" that search the Internet not only enthusiastic, but the negative feedback and appreciated them.

  Galina Romanenko