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

Description: Description: Description: Description: 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.

Description: Description: Description: Description: Breech presentation

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.

Description: Description: Description: Description: Oblique presentation

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.

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