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Pelvic birth


Danger of childbirth with pelvic fetal presentation

First, the pelvic end (or priest) of the baby byVolume is much smaller than its head. Therefore, it presses with less intensity on the lower part of the uterus. The uterus responds worse, and the cervix becomes worse. Ieto all slows down the birth and leads to generic weakness.

Secondly, the head of the child in the process of childbirth can be overturned, and this often leads to injuries.

Often there is an infringement of an umbilical cord between a wall of a generic canal and a head, a throwback of handles of the kid upwards to a head. The flow of blood to the fetus makes it difficult to advance the umbilical cord, hypoxia begins.

To a large extent, all of the above applies to children who are ill-fed. Their body size is still small, the head is usually large, and this greatly hinders birth in the pelvic presentation.

It is also possible the prolapse of the umbilical cord or the legs of the fetus from the uterus before the onset of intense labor. As a result, the infection can rise to the uterus and isolate the baby, and his mother (this is postnatal endometritis).

In addition, the boys are particularly disadvantaged. In the breech presentation at delivery there is quite a significant pressure on the scrotum, which can cause her injuries.

Mechanism of the tatami genera

The first moment is the inner turn of the buttocks. It begins during the transition of the buttocks from the wide part of the pelvis to the narrow one. This happens so that the transverse size of the buttocks in the pelvic outlet is in the direct size of the pelvis itself, the buttocks next to the lumbar arch, the posterior one is set over the coccyx. In this case, the trunk of the fetus performs a lateral slight bending by the convexity downwards, correspondingly to the bending of the axis of the pelvis.

The second moment - lateral flexion of the spineFetus (lumbar part). Further movement of the baby leads to a lateral bending of his spine. The rear buttock is then rolled over the crotch and the front buttock finally leaves from under the pubic articulation. The toes of the toddler at this time enter a transverse dimension to the size of the entrance to the pelvis, through which the past-progenitors already pass. In this case, the baby's body turns slightly forward.

The third moment is the inner turn of the shoulders, andAlso with this bound torso. This turn ends with the establishment of the shoulder-hangers with a straight exit size. The front shoulder of the child at the same time fits under the laminar arch, the posterior is placed above the crotch in front of the coccyx.

The fourth point is the flexion of the lateral cervicothoracic part of the spine. At such a moment, the handles and shoulder girdle are born.

The fifth moment is the internal rotation of the head. The head enters with its small size in the oblique size of the entrance to the pelvis, and opposite to that in which the shoulders already passed. The head makes an internal turn in the process of transition into the narrow part of the pelvis, as a result of which a sagittal suture appears in the direct exit size, and the suboccipitary fossa is a pivotal joint.

The sixth moment is the bending of the head, its eruption: the nasal perineum is rolled out successively: the chin, the mouth, after the nose, the forehead of the baby's head.

The head is cut by an oblique small size, likePre-parenchymal presentation. Much less often is the eruption of the fetal head under the palate-frontal size, and this leads to stretching and rupture of the perineum.

Factors that are favorable for natural pelvic birth

For natural species, the following are favorableFactors. This is a full-term pregnancy (more than 37 weeks); A female fetus; The average estimated mass of the baby from 2500 to 3600 grams, as well as the normal size of the mother's pelvis; Clean or breech-foot praise; Availability of qualified personnel and equipment.

When all these conditions are met, then you can try to build on your own, otherwise it's best to plan your caesarean section in advance.

Factors that are not favorable for natural delivery

Adverse factors for pelvic delivery areThe mass of the fruit is less than 2500, or more than 3600 grams; Preterm baby, premature birth, leg variant of pelvic presentation; Male fetus; Overextension (submitted ultrasound) of the fetal head; The lack of a qualified specialist who knows how to lead a pelvic birth.

If at least one of these factors is present, then the risk of complications is great. It is best not to risk and give birth to a child with caesareans.

How are births performed in pelvic presentation of the fetus

It is recommended from the very first stage of labor with pelvic tenderness to lie on its side, facing the back of the child.

When the baby's buttocks are shown from the genital slit, the most common woman is the perineum (this is an episiotomy). This is necessary in order to reduce the possibility of injury to the head of the fetus.

Obstetricians follow closely the baby's heartbeat with KTG. When the baby is born before the navel, and the head of it just enters the vtas and presses the umbilical cord, because of this, hypoxia often develops.

If a child is not born within 7-10 minutes after this, there is a danger to his health and life. Therefore, in such births, drugs that stimulate activity are always used.

When the placenta is born, to prevent postpartum haemorrhage, a woman is administered oxytocin and methylergometrine, causing a decrease in the uterus.

When an emergency caesarean section is indicated

Having started pelvic birth naturally, a specialistmay decide that a cesarean section is still necessary. In this case, it is called acute, since it is performed after the onset of contractions. It can happen in the following cases. This is the fall of the hands, legs or umbilical cord of the child; placental abruption; weakness of labor, with the opening of the cervix uterine less than 5 cm; acute fetal hypoxia; discoordination of labor.

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