The meaning of determining the fetal position in labor and birth

The article was professionally consulted by Specialist Doctor I Le Hong Lien - Department of Obstetrics and Gynecology - Vinmec Central Park International General Hospital.

When taking antenatal care, surely every pregnant woman knows the position of the fetus, especially in the last months of pregnancy. But to know what the fetal position means during labor and delivery, not all mothers know. The position of the fetus is one of the factors for predicting the birth and monitoring the process of labor and delivery is very important.

The fetal position is the lowest presentation of the fetus before the upper waist of the mother's pelvis to the birth canal and out of the mother's body first.
Before 24 weeks of age, the fetus often rotates unstable in the uterine cavity. As the fetus grows larger, the less the position is turned, the better the stability of the fetal position is to prepare for the process of labor and delivery.
Determining the position of the fetus is one of the steps to prepare for the birth process, and is a factor that helps doctors predict a birth. There are many different types of fetal position, depending on the movement of the fetus in the uterus.

Thai throne includes two large types, horizontal or vertical.
2.1 Vertical position The vertical position refers to the fetal axis parallel to the mother's body axis, the vertical position can be the head or the buttocks.
Head position (frontal position): That is, the head of the fetus presents to the mother's pelvis, based on the relationship between the head and body of the fetus, the head position is divided into many different types:
Crest position: Most pregnant women give birth in a crest position, corresponding to the baby's head bending to the maximum, the chin touching the body. Anterior fontanelle: The position where the head is in an intermediate position, the anterior fontanelle of the fetus is presented in front of the upper waist of the mother's pelvis. Forehead: The head is also in the intermediate position, but the forehead is presented in front of the pelvis. Face: The face of the fetus is maximally supine, the nape of the neck touching the back.

Butt position (reverse pregnancy): This is a vertical position, but the baby's bottom is presented in front of the upper waist. There are two types:
Full buttocks: That is, the buttocks and 2 legs are presented in front of the upper waist. When the baby is born, the bottom of the baby will come out first. This is the most common position of the breech position. In this type of pregnancy, a woman can still give birth naturally if other conditions allow. Incomplete breech has the following types: Buttock type: When giving birth, the buttocks will come out first, the baby is in the position of straightening the legs above the head. Knee and foot type: Your baby's legs will come out first because their feet are lower than the bottom. 2.2 Transverse position The fetal position is not located along the longitudinal axis but is horizontal to the uterus, the fetal axis may be perpendicular to the mother or in some cases the fetal axis deviates from the mother's body at an angle of 45 degrees, in general it can oblique and unstable and the fetal head may be on the right or left side.
The horizontal throne is dangerous for both mother and child. Pregnant women who are diagnosed with this type of pregnancy should be actively monitored in the last 3 months of pregnancy and need to rest in the last month to avoid premature rupture of membranes, which is dangerous to the fetus.

Determining how the position of the fetus is very important in care, prognosis and is a determining factor in how to give birth. The meanings of determining the position include:
Choosing the right delivery method, vaginal birth or caesarean section has many determining factors, in which the fetal position is an important factor. If the woman has a breech position and other factors are favorable, a normal delivery is indicated. The current breech position is rarely indicated for normal delivery, if any, it must have all other favorable factors. Indications for cesarean section when: Abnormal positions such as forehead, face, and horizontal positions. Especially in the transverse position: Although not common, but very dangerous, it needs to be monitored regularly to avoid fetal distress during labor. Prognosis of a birth: From the position of the fetus and a number of other factors from the mother, the fetus, the doctor will then give a prognosis for a birth, preventing risk factors for the mother and the fetus. One of the causes of fetal distress is an abnormal position of the fetus. Abnormal fetal position makes the labor process prolonged, the fetus may suffocate due to lack of oxygen supply. Fetal failure is very dangerous, if not detected and treated promptly, the fetus can cause brain complications or possibly death. Monitoring during labor: The fetal position has been identified, but during labor, the fetal position is found to have no progress, if the fetal position does not enter or progress when the cervix is ​​completely dilated, then there is only intend to have surgery. The fetal position is determined by fetal ultrasound and examination. Determining the position of the fetus is very important at the end of pregnancy. Regular prenatal check-ups and ultrasounds should be done at the end of pregnancy to determine the position of the fetus, monitor the development of the fetus, from which the doctor will give advice and consider factors between normal delivery and cesarean section.
To protect the health and safety of both mother and baby during pregnancy, pregnant women should use all-inclusive maternity services at reputable facilities. At Vinmec International General Hospital, there is a package maternity service as a solution to help pregnant women feel secure because of the companionship of the medical team throughout the pregnancy. When choosing Maternity Package, pregnant women can:
The pregnancy process is monitored by a team of highly qualified doctors Regular check-ups, early detection of abnormalities The package pregnancy helps to facilitate Convenience for the delivery process Newborns receive comprehensive care, Specialist I Le Hong Lien has been an obstetrician-gynecologist at Vinmec Central Park International Hospital since November 2016. Doctor Lien has over 10 years of experience as a radiologist in the Department of Ultrasound at the leading hospital in the field of obstetrics and gynecology in the South - Tu Du Hospital.