Situation and prelying of a fruit
the Provision of a fruit is the relation of its axis (which passes through a head and yagodichka) to a longitudinal axis of a uterus. The provision of a fruit can be longitudinal (when axes of a fruit and a uterus coincide), cross (when the axis of a fruit is perpendicular uterus axes), and also slanting (an average between longitudinal and cross). > >
of a fruit is defined p by em depending on that its part which is in area of an internal pharynx of a neck of a uterus, that is in the place of transition of a uterus to a uterus neck (the prelying part). The head or the pelvic end of a fruit can be the prelying part, the part at cross situation prelying is not defined.
Till 34 weeks the provision of a fruit can change, after this term it usually becomes stable.Head prelying
Head prelying is defined by
approximately in 95 - 97% of cases. The most optimum is occipital prelying when the head of a fruit is bent (the chin is pressed to a breast), and at the birth of the kid there is a nape forward. The leading point (that which the first goes in patrimonial ways) is the small fontanel located on a joint parietal and occipital bones. If the nape of a fruit is turned kpered, and the face of a kzada is a forward type of occipital predesire (in such situation there are more than 90% of childbirth) if on the contrary - that back. In a rear view occipital prelying childbirth is more difficult, in the course of childbirth the kid can be developed, but childbirth at the same time usually longer. the pelvic end of a fruit can deviate by
At head prelying to the right or to the left, it depends on into what party the fruit back is turned.to
Also allocate razgibatelny types head prelying when the head is in a varying degree unbent. At small extension when the leading point is the big fontanel (it is located on a joint frontal and parietal bones), speak about perednegolovny prelying. Childbirth in natural patrimonial ways is possible, but they proceed longer and more difficult than at occipital prelying as the head is inserted into a small pelvis by the big size.
Therefore forward - head prelying is a relative indication for operation of Cesarean section. The following extent of extension is a frontal prelying (it meets seldom, in 0,04 - 0,05% of cases). At the normal sizes of a fruit childbirth in natural patrimonial ways is impossible, the operational rodorazresheniye is required. And at last the maximum extension of a head is a front prelying when the fruit face is born the first (it meets in 0,25% of childbirth). Childbirth in natural patrimonial ways is possible (at the same time the patrimonial tumor settles down in the lower half of the face, in lips and a chin), but they are rather traumatic for mother and a fruit therefore often the issue is resolved also in favor of Cesarean section.Diagnostics of razgibatelny predlezhaniye is carried out by
at vaginal research in the course of childbirth.
Pelvic prelying of a fruit
Pelvic prelying meets in 3 - 5% of cases and shares on foot when predlezhat fruit legs, and buttock when the kid as if squats, and predlezhat his yagodichka. Buttock prelying is more favorable.Childbirth in pelvic prelying is considered as
pathological of - for a large number of complications at mother and a fruit as less volume pelvic end is born the first and at removal of a head there are difficulties. At foot prelying the doctor a hand detains the child`s birth until that does not sit down on hunkers not to allow loss of a leg, after such grant the first yagodichka are born.
Pelvic prelying is not the absolute indication for Cesarean section. The issue of a method of a rodorazresheniye is resolved depending on the following factors:
- of the sizes of a fruit (at pelvic prelying the fruit more than 3500 gr, whereas is considered large at usual childbirth - more than 4000 gr);
- of the sizes of a basin of mother;
- of a type of pelvic prelying (foot or yagolichny);
- of a floor of a fruit (for the girl childbirth in pelvic prelying is accompanied by smaller risk, than for the boy as at the boy injury of genitals is possible);
- of age of the woman;
- of a current and result of the previous pregnancy and childbirth.
For turn of a fruit after 31 weeks recommends the following exercise: to lay down on the right side, to lie down 10 minutes, to turn over quickly on the left side, in 10 minutes on right again, to repeat
Contraindications for performance of similar exercises are the complicated course of pregnancy (gestoz, threat of premature birth), a hem on a uterus after operation Cesarean section in the past, prelying of a placenta, a uterus tumor.by
applied external turn of a fruit Earlier (the doctor through a stomach tried to displace a fruit head below). Now it is not applied from - for low efficiency and a large number of complications, such as a premature otsloyka of a placenta, premature birth, violation a condition of a fruit.
If pelvic prelying remains, then in 2 weeks prior to childbirth the pregnant woman is sent to a hospital where the plan of a rodorazresheniye is formed.
the Cross and slanting provision of a fruit
Cross and slanting provisions of a fruit are the absolute indication for operation Cesarean section, childbirth in natural patrimonial ways is impossible. The prelying part is not defined. Such situation are defined in 0,2 - 0,4% of cases. The turns applied earlier for a leg in the course of childbirth are not applied in view of big injury to mother and the kid now. Occasionally similar turn can be applied at twins when after the birth of the first fruit, the second adopted the cross provision.
Cross situation can be from - for tumors in a uterus (for example, myomas) which prevent to adopt the normal provision, at the multigiving birth women owing to restretching are a uterus, at a large fruit, at a short umbilical cord or its obvitiya around a neck.
in the absence of the reasons interfering turn of a fruit on a head can carry out the same exercises that at pelvic prelying. At slanting situation it is necessary to lie more on that side where the back is mainly turned.weeks before childbirth the woman is hospitalized by
At twins childbirth in natural patrimonial ways is possible
if both fruits are in head prelying or if the first (which is closer to an exit from a uterus and will be born the first) is in head prelying, and the second in pelvic. If on the contrary the first is in pelvic prelying, and the second in head, the situation is adverse as after the birth of the pelvic end of the first fruit, kids can be hooked by heads. the issue is resolved by
When determining cross provision of one of fruits in favor of operation Caesarian section.by
Even at a favorable arrangement of fruits, the issue of a rodorazresheniye method at twins is resolved not only proceeding from situation, but also depending on many other factors.