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What quack recommends for you today is the content about “fetal position”.

Expectant mothers who want to give birth naturally should be very concerned about the fetal position, because whether the fetal position is correct or not is one of the key factors to decide whether to give birth naturally or by caesarean section. Let’s talk about the fetal position today.

Fetal position is the position and position of the baby in the womb. The most common positions are head position, hip position and transverse position. Head position refers to the position of the baby in the womb with the head under and the ass on; The breech position is just the opposite, which refers to the position of the baby’s ass under and head on; Transverse position refers to the fetal baby lying horizontally in the uterus.

Some expectant mothers will mistakenly think that the head position represents the correct fetal position, which is not necessarily Oh, because the head position is also divided into occipital anterior position, occipital posterior position, facial position, frontal position, etc. only the occipital anterior position is what we call the more correct fetal position, and it is also the most conducive fetal position for smooth delivery. In addition to the occipital anterior position, other fetal positions belong to abnormal fetal position.

Many expectant mothers were very worried when they found that the fetal position was not correct 28 weeks or even earlier, but in fact, it was not necessary, because at this stage, the baby was still relatively small, there was relatively more amniotic fluid, and the space in the uterus was very abundant. The baby would turn over and move inside, and maybe adjust the position back to normal. Generally, at about 30 weeks of gestation, most babies can naturally turn to the head down position.

Of course, if it is close to delivery and the position of the baby has not been adjusted, it is not necessary to have a caesarean section. Because in the process of delivery, strong uterine contraction will push the baby to the position of the uterine mouth, which is likely to change the baby’s posture, making the original posture into the occipital anterior position suitable for spontaneous labor.

However, if the following two situations occur at this time, caesarean section should be considered: one is the expectant mother of the first pregnancy, who is still breech at the time of labor, and the doctor will generally recommend caesarean section; The other is that if the fetus is in transverse position at the time of labor, caesarean section must be adopted.

Guagua wants to tell you that although natural childbirth is good, it may not be suitable for every mother. The safety of mother and child is the most important!

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The following is Gao Yu, deputy chief physician of Obstetrics of the Sixth Affiliated Hospital of Sun Yat sen University. I hope it will be beneficial to you. For the details of the expert interview, please check the special topic: incorrect fetal position, carefully select spontaneous labor after identifying the causes (click the previous text to jump to the special page)

Q: how long do you have to do fetal position examination after pregnancy?

Dr. Gao Yu answers:

Before 28 weeks, the fetal position is very unstable and easy to change without special examination. However, after 28 weeks, the fetal orientation (hand touch or B-ultrasound) should be checked every two weeks. After 30 weeks, if the fetal orientation cannot naturally turn to head position, intervention should be carried out.

The commonly used examination methods include “four step technique”, vaginal examination and B-ultrasound (but at present, the resolution of B-ultrasound is limited, which can only distinguish the head position and hip position, but can not specifically distinguish the occipital anterior position, occipital posterior position and occipital transverse position, and the fetal head will be blocked by the pelvis after entering the pelvis, affecting the imaging of B-ultrasound).

Q: when is the best time to correct fetal position? How to correct?

Dr. Gao Yu answers:

Tire orientation correction should not be too early or too late, preferably no more than 34 weeks.

There are body position correction methods and artificial methods (external inversion method operated by doctors). The implementation time of these two methods is different. The method of body position is mainly chest knee position. Pregnant women can operate by themselves at home. The appropriate time is 30-34 weeks of pregnancy, because the fetus will not be too large during this time, the burden of pregnant women is small, the heart is easier to bear, and the correction effect is better.

The artificial method is the external inversion operation operated by the doctor. Specifically, under the monitoring of B-ultrasound, an external force is applied to the fetus along the longitudinal axis of the fetal trunk to turn the fetal position into the head position. It is generally carried out when approaching delivery (term). Because the operation is difficult and dangerous, if the fetus has hypoxia during the implementation, it needs to be delivered by caesarean section immediately, In addition, at this time, the fetal volume reaches a certain degree and the activity is limited. After correction, the fetal position is not easy to return to the original abnormal fetal position. Even after correction, oxytocin can be used to expose the fetal head first and further connect with the human pelvis for fixation.

Whether the fetal position can be corrected, the doctor’s consideration includes the factors leading to abnormal fetal orientation, whether there is the possibility of spontaneous labor after correction, whether the pregnant woman herself has the conditions for spontaneous labor, etc. The effect of fetal orientation correction by pregnant women and pregnant women with small fetus (no more than 7 kg) is more ideal.

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