What is the fetal position? What to do when diagnosed with breech position?

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

The breech position is where the baby's head is above the chest, and the baby's bottom is towards the bottom of the mother's pelvis. The breech position has a very high risk of danger to both mother and baby, which can be fatal to the fetus and increase the risk of complications for the mother.

The fetal position is the lowest part of the fetus to the mother's pelvis, the first part to come out of the womb during labor. During pregnancy (about under 28 weeks) the fetus will often move, change position in the womb. The closer to the last weeks of pregnancy, the position of the fetus will be more stable. Usually, by week 34-36 onwards, most of the fetal position will be stable, with little rotation.

The inverted side, also known as the breech position, is the bottom part of the baby's bottom or legs, the mother's pelvis. The baby's head will be at the top near the mother's chest. The rate of breech presentation is quite low (1 - 3%) in births. However, these are births that can pose many dangers to both mother and baby.

The breech position is divided into 2 types:
Full breech position: The baby's knees are bent, the thighs are bent into the body like a squatting position. The baby's bottom will come out of the mother's body first. This is also the most common position of the breech position.
Incomplete breech:
Butt type: Baby's bottom is facing down under the mother's pelvis, legs are extended straight up over the head. Leg type: 2 legs straight. Knee type: the fetus kneels in the uterus.

The two factors that form the breech position are preterm birth (the fetus has not yet adjusted to the forward position) and the second factor is the factors that hinder the normalization of the fetus. With 2 specific main causes:
Mother's cause:
The uterus of a pregnant mother is small, it is difficult to adjust in people who have given birth many times. Abnormal uterine shape such as malformed uterus, double uterus, bicornuate uterus, uterus with fibroids, uterus compressed by ovarian cysts. Pregnant women have narrow pelvis. Causes from the fetus:
Extreme large head, hydrocephalus. Multiple pregnancy, malformed pregnancy. Thai malnutrition. Due to fetal appendages such as placenta previa, polyhydramnios, lack of amniotic fluid, short placental cord or due to cord wrapping around the neck.

A breech pregnancy is not a rare case, but it is an abnormal condition of the fetus and has many dangerous factors for both mother and baby. Situations that may occur when carrying a breech pregnancy is considered dangerous, including:
In the breech position, the fetus is prone to rupture of amniotic fluid before and after labor, the placental stalk will follow the amniotic fluid out. Leading to amniotic fluid depletion, the fetus lacks oxygen, which can easily cause asphyxia and death to the fetus. Breaking rancid water is also the cause of loss of natural labor pain in pregnant women. The breech pregnancy makes it difficult for the fetus to come out of the womb. Normally, in the first position, the baby will come out first, then the shoulders and legs will go back. The parts are neater when coming out of the womb. As for the breech position, the baby's legs or buttocks will come out first, then the shoulders and head. When the baby's bottom or legs come out first with improper handling, it can be very difficult for the baby's head to come out, leading to the baby suffocating. Or there is a case where the baby has broken limbs because he cannot get out of the mother's body conveniently. The breech position is dangerous for both the mother and the baby with difficult births that can cause complications for the pregnant woman.

Cases of breech position need to be examined regularly and carefully in the last weeks of pregnancy. Careful prognosis to have an accurate and safe treatment plan for both mother and baby.
Normally, there will be 2 ways of giving birth in a breech pregnancy: vaginal birth (vaginal birth) and cesarean section. Caesarean section is considered the best option for breech cases.

Just having a misdiagnosis and choosing the wrong birth method can cost the baby's life. Leaving heavy psychological trauma for pregnant women. Therefore, it is necessary to have a reputable antenatal clinic to be consulted by specialist doctors and refer to methods to help the fetus return to the right position. The most important thing is still early diagnosis and safe pregnancy monitoring.
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