Usually, from the 28th week, the
fetus start to rotate its head to pelvis for fixing the position of
presentation – and this is the most convenient position for delivery.
The pregnant women, the most ideal presentation
for the convenient delivery is the cephalic presentation where the fetus is in
a longitudinal lie and the head enters the pelvis. However, there are some
cases in which the fetus is in different positions then doctors have to process
some operation for the pregnant women. In these cases, normal delivery will
cause some danger out of intention.
How many kinds of presentation are there?
Presentation refers to which anatomical
part of the fetus is leading, that is, is closest to the pelvic inlet of the
birth canal. They are divided into 3 forms: cephalic presentation, breech
presentation, shoulder presentation.
Cephalic
presentation
Cephalic
presentation
There are 4 positions:
·
If the head bows well and doctor can touch the minor
fontanelle, it is the vertex presentation.
·
If the head does not bow well and doctor can touch the
bregma, it is the bregma presentation.
·
If the head rises slightly, and doctor can touch from
the nose and mouth, it is the sinciput presentation.
·
If the head rises well, and doctor can touch the chin,
it is the face presentation.
Breech
presentation
A breech presentation is defined as the
condition in which the baby is in longitudinal lie and the podalic pole
presenting at the pelvic brim with the head occupying upper pole of uterus,
including 2 kinds:
·
Complete breech: the baby is sitting cross-legged and
the doctor can touch the bottom and feet.
·
Incomplete breech: includes Frank breech - the baby's
bottom comes first, and its legs are flexed at the hip and extended at the
knees; Footling breech - one or both feet come first, with the bottom at a
higher position; Kneeling breech - the baby is in a kneeling position, with one
or both legs extended at the hips and flexed at the knees.
Breech
presentation
Oblique
presentation
Oblique presentation refers to a
malpresentation at childbirth where the baby is in a transverse lie (its
vertebral column is perpendicular to that of the mother), thus the leading part
(the part that enters first the birth canal) is an arm, shoulder, or the trunk.
It usually happens when the mother gives birth to twins.
Oblique
presentation
What are methods for each kind of presentation?
Cephalic
presentation
When detecting vertex and face
presentation, pregnant woman can deliver by natural mean. If the fetus has the
face presentation but it turns the chin against the mother’s back then an
operation is necessary.
In case of detecting the forehead and
bregma presentation, pregnant women should take the operation mean. The reason
is that the baby’s head rises in the middle so the diameter is big and it
cannot pass the pelvis frame.
Breech
presentation
In the case of breech presentation, doctors
usually apply the selective operation method, which means that not all cases
need an operation. However, to ensure high safety level for both mother and
baby, doctors mainly recommend operation. In the complete and incomplete
breech, pregnant women can give birth by natural or operation mean. It depends
much on the mother’s health, and the rotation of the fetus during the delivery
then the doctors decide the suitable solution for the pregnant women.
For footling breech, the best method is
operation. In addition, there are some other variations such as twins’
delivery, the first baby heavier than 3kg, etc. the doctor applies the
operation.
Shoulder
presentation
This is the case you should apply the
operation, because the body cannot pass through the pelvis frames.
