Pelvic presentation of the fetus at birth

Pelvic presentation of the fetus at birth

Pelvic presentation occurs when the fetus exits, at the time of birth, with the seat or legs forward, instead of the head. This causes a long and painful labor, because the seat or the legs do not manage to dilate the cervix as easily and quickly as the head. This presentation is a risk, because multiple accidents or problems can occur and it also has an increased risk of fetal mortality, which is why it requires emergency caesarean section.

The presentation of the fetus in the womb at the time of birth is essential for its success. Almost all babies (over 90%) have a normal position, ie cranial at birth. This means that the first part of the body that comes out first at the time of vaginal birth is the head. All other presentations are considered abnormal and often require birth by Caesarean section.

Pelvic presentation

In the pelvic presentation the fetus can be placed at the time of birth in several ways:

  • with the front seat, with the legs bent upwards and with the right knees;

  • with the front seat, the legs bent upwards and the knees flexed (and the legs crossed) - at the upper narrowing (at the exit) the pelvis and the legs appear first - pelvic-podal presentation;

  • with the front seat and one leg bent upwards with the knee flexed and the other leg straight; the latter is also the first to come out at the time of birth - pedal presentation.

What are the causes of pelvic presentation?

  • uterine malformations;

  • tumors;

  • multipara;

  • prematurity;

  • fetal malformations;

  • macrosomia;

  • dead in the womb;

  • variations in the amount of amniotic fluid;

  • low insertion of placenta etc.

What are the symptoms and how is the diagnosis made?

There are several signs and symptoms that indicate an abnormal presentation of the fetus:

  • feeling of pressure or pressure or embarrassment in the right epigastric and hypochondriac;

  • removal of meconium after rupture of membranes.

Also, the palpation of the fetal sac may indicate another series of abnormal signs. The investigations that are carried out to diagnose this presentation are:

  • ultrasound;

  • pregnancy radiograph in 3rd trimester.

Can the fetus be returned to the womb at the time of birth?

Pelvic birth involves 3 consecutive births in the following order:

  • birth of the pelvis;

  • birth of shoulders;

  • the birth of the head.

The return of the fetus by the doctor may be attempted. He gives the pregnant woman an ultrasound, and guided by the images offered by it, she gently presses her mother's abdomen, in key points, to encourage the fetus to change its position. However, if it is found that the fetus has an abnormal position after the 37th week of pregnancy, this maneuver is impossible to achieve, due to the accumulation of amniotic fluid.

Therefore, it is advisable to go to all prenatal consultations and analyzes to uncover such problems early.

If the doctor finds the diagnosis after 37 weeks of sacking or during birth, he uses forceps or vacuum to remove the fetus.

What complications can occur?

Unfortunately, this presentation is a high risk for the girl. There is a very high risk of fetal mortality in this type of fetal position at birth, between 3% and 6%. Other complications that may occur are:

  • premature rupture of membranes;

  • maternal soft canal lesions;

  • fetal prematurity;

  • fetal nerve injuries etc.

Tags Natural birth