Rus Articles Journal

Pregnancy, childbirth and pelvic prelying of a fruit. How to correct?

Shortly before birth the kid holds a certain position in a uterus. In most cases it is placed the head down - towards to an exit from a uterus, and a back turns to the left side. This correct, so-called head prelying, the most convenient for childbirth. Quite so about 90% of children are born.

of the Kind of pelvic predlezhaniye

However today we will talk about those cases when legs or buttocks are the prelying part. Frequency of pelvic prilezhaniye , by various estimates, is in limits of 3 - 5% from total of newborns. In 67% of such pregnancies the kid sits buttocks in a pelvic ring of mother, his legs are bent in coxofemoral joints, and knees at the same time are straightened. Less often prelying when the child enters a pelvic ring of mother not only buttocks, but also legs, more precisely, than a stupnyama meets mixed buttock (20,0%). Carry to pelvic prelying also full foot prelying when legs of the baby are slightly unbent in coxofemoral and knee joints; and the mixed foot prelying when one leg almost direct, and another is bent in a coxofemoral joint; and knee prelying when the kid predlezhit the bent knees.

the Factors influencing pelvic prelying

Exist certain conditions owing to which the kid holds the wrong position. Allocate the following factors:

at the same time the child possessing a self-preservation instinct holds for himself the most comfortable position. Doctors and a hereditary factor do not disregard: if mother was born in buttock prelying, then there is a risk, as her kid will reach the same position.

Diagnostics of pelvic prelying

Pelvic prelying of a fruit is diagnosed by

first of all according to external obstetric and vaginal research. At external research the inactive part whereas in day of a uterus the large, round, firm, mobile, balloting part (a fruit head) is defined is defined prelying to an entrance to a basin large, irregular shape, a softish consistence. Higher standing of a bottom of a uterus over a pubis which is not corresponding to pregnancy term is characteristic. Heartbeat is distinctly listened at the level or above a navel. During of vaginal research at purely buttock prelying the softish volume part on which the pakhovy bend, a sacrum and a tailbone is defined is felt strong. At the mixed buttock and foot prelying fruit feet are defined.

not only pelvic prelying, but also its look is possible to define

by of ultrasonography . The provision of a head of a fruit and extent of its extension is estimated. Excessive extension is fraught serious complications in labor: trauma of cervical department of a spinal cord, cerebellum and other damages.

revolution Attempt

the Pelvic prelying diagnosed till 28 weeks of pregnancy should not cause concerns, there is enough of dynamic supervision . With 29 - 30 weeks tactics is directed to correction of pelvic prelying on head. There are conservative methods. The corrective gymnastics which efficiency makes of 75 - 85% is for this purpose appointed . However it cannot be applied at anomalies of development of a fruit, pregnancy interruption threat, a hem on a uterus, infertility and not incubation of pregnancy in the anamnesis, a gestoza, prelying of a placenta, it is not enough - or mnogovodiya, anomalies of development of a uterus, a mnogoplodiya, a narrow basin, a serious ekstragenitalny illness. Except gymnastics nonconventional methods are used by : acupuncture / akupressura, aromatherapy, homeopathy, and also suggestion force, light and sound impacts on a fruit from the outside, swimming.

If pelvic prelying remains, on the term 35 - 37 can execute weeks the external preventive turn of a fruit on a head offered by B. L. Arkhangelsky whose efficiency fluctuates from 35 to 87%.

External preventive turn the doctor of high qualification in stationary conditions has to carry out

where Cesarean section can be in case of need made and necessary help is given to the newborn. After turn it is necessary to consolidate the achieved result. Are for this purpose used by a bandage and the exercise determined by promoting fixing of a head of the child in the necessary situation. However if the kid, despite everything the made efforts, did not turn over, you should not despair: even in this case the possibility of spontaneous childbirth remains .

the Choice of a method of a rodorazresheniye

to the Woman with pelvic prelying of a fruit needs to lay down in a hospital in 38 - 39 weeks for inspection and the choice of rational tactics of conducting childbirth. a rodorazresheniye Method is defined proceeding from the number of childbirth, age of mother, the obstetric anamnesis, term of pregnancy, readiness of a female organism for childbirth, the sizes of a basin and other factors. Pelvic prelying of a fruit is not the absolute indication to Cesarean section, however in cases when it is combined with various complicating factors, the issue is resolved in favor of of an operational rodorazresheniye .

Indications to to Cesarean section in a planned order at the full-term pregnancy are age of pervorodyashchy more than 30 years; severe form of a nephropathy; the ekstragenitalny diseases demanding switching off of attempts; the expressed violation of a fatty exchange; narrowing of the sizes of a basin; the estimated mass of a fruit pervorodyashchy and over 4000 g have over 3600 g at povtornorodyashchy; fruit hypotrophy; symptoms of a hypoxia of a fruit according to a kardiotokografiya; violation of a blood-groove at a doplerometriya; a Rhesus factor - the conflict; extension of a head 3 - y degrees according to ultrasonography; unpreparedness of patrimonial ways to terms of gestation 40 - 41 week; perenashivaniye; foot prelying of a fruit; pelvic prelying of the first fruit at polycarpous pregnancy and other factors.

Childbirth is conducted by

through natural patrimonial ways at a good shape of future mother and a fruit, the full-term pregnancy, the normal sizes of a basin, the average sizes of a fruit, at the bent or slightly unbent head, existence of readiness of patrimonial ways, at purely buttock or mixed buttock prelying.

it is the best of all than

that at pelvic prelying a fruit patrimonial activity began spontaneously . In the first period of childbirth the woman in labor needs to observe a bed rest and to lie on that side towards which the fruit back is turned to avoid complications (premature izlity waters, loss of a leg of a fruit or loops of an umbilical cord). Childbirth is conducted under monitor control for heartbeat of a fruit and sokratitelny activity of a uterus. The obstetric care in the form of a grant which purpose - to keep a fruit chlenoraspolozheniye is given to in the second period of childbirth (legs are extended along a trunk and are pressed to a breast by fruit handles). At first the child is born to a navel, then - to bottom edge of a corner of shovels, then - handles and a humeral belt, and then - a head. At the child`s birth to a navel its head presses an umbilical cord, and the lack of oxygen therefore till the full birth of the child has to pass no more of 5 - 10 minutes develops, differently consequences of oxygen starvation will be very negative. Also the crotch section is made by to accelerate the birth of a head and to make it less traumatic.

Childbirth at foot prelying in natural patrimonial ways is only conducted by

at povtornorodyashchy at good patrimonial activity, readiness of patrimonial ways, the full-term pregnancy, the average sizes (weight to 3500 g) and a good shape of a fruit, the bent head, refusal of the woman of Cesarean section. At the same time carrying out an obstetric grant consists in the following: cover with a sterile napkin genitalia and the palm turned to a vulva, interfere with premature loss of legs from a vagina. Deduction of legs promotes full disclosure of a uterine pharynx. The fruit during an attempt as if squats, at the same time the mixed buttock prelying is formed. Counteraction to the born legs is rendered before full opening of a uterine pharynx. After that usually the fruit is born without difficulties.

the Condition of the children born in pelvic prelying in natural patrimonial ways requires special attention. The hypoxia postponed in labor can adversely be reflected in nervous system of the child, such pathology as dislocation of a coxofemoral joint is possible. Surely have to be present at childbirth neonatolog and the resuscitator. At observance of these measures of precaution the kids born thus do not differ in development from other children.