Causes and preventive measures of fetal dislocation

Introduction: A large number of expectant mothers may find abnormal fetal position during pregnancy, which is generally called sitting fetus. Abnormal fetal position has a certain influence on the baby to a certain extent, and it also causes great pain to the delivery of pregnant women. Therefore, once the abnormal fetal position is found, it is necessary to discuss with the doctor and choose what kind of production method is the best.

Pregnant women's understanding of fetal malposition. What are the causes of fetal dislocation? As for the causes of abnormal fetal position, it is related to the size of gestational age, the size and shape of pelvic cavity, the size and implantation position of placenta in uterus, abdominal muscle relaxation of multipara, multiple pregnancy, abnormal amniotic fluid, too short umbilical cord, whether there are intrauterine tumors (such as) or abnormal uterine development (such as bicornuate uterus or intrauterine diaphragm).

But in most cases, the causes of fetal malposition are not necessarily classified, that is, the so-called reasons are unknown.

Generally speaking, obstetricians and gynecologists think that when the fetal position is still abnormal at 36 weeks, it almost means diagnosis. Although very few women still have the opportunity to change their fetal position before delivery, if the fetal position is still abnormal at 36 weeks of pregnancy, they should be fully communicated and discussed to decide the mode of delivery.

The incidence of fetal malposition "fetal malposition" has different incidence in different weeks of pregnancy. For example, about 33% of fetal malposition is in the fifth month of pregnancy, while only about 8.8% is in the eighth month, and only about 5% is in the ninth month of pregnancy, which means that about 90% of fetal malposition will automatically turn to normal head position.

What are the common fetal malposition? First, breech position: the fetus is in the breech position where the buttocks are exposed first, or the feet or knees are exposed first, which is divided into single hip, mixed hip and foot position.

Second, the horizontal position: the horizontal position where the arms and shoulders are exposed first during childbirth.

Third, the head position is not correct: the above two fetal positions are common fetal positions, but some fetuses are also? Even if the head is down, there are cases of fetal malposition, which is called cephalic malposition.

Incorrect head position can be divided into four situations:

1. Due to poor flexion, the fetal head is exposed to the front, forehead and face.

2. Occipital posterior position and occipital transverse position are due to poor rotation of fetal head.

3. High straight position, poor rotation and poor buckling.

4. Uneven anteroposterior, posterior and lateral tilt of fetal head. These are all fetal malposition.

These abnormal fetal positions set obstacles for the delivery of pregnant mommy, which easily leads to dystocia.

Fourth, the compound presentation: the fetal head or buttocks combined with upper limb prolapse, while entering the pelvis is a compound presentation. Generally speaking, it is common for the head and hands to enter the pelvis at the same time, and it is impossible to give birth naturally if it is not corrected.

The clinical manifestation of abnormal fetal position: 1, which was confirmed by abdomen, * * and B-ultrasound after 28 weeks of pregnancy.

2, breech position diagnosis: abdominal examination of the uterus is vertical oval, the bottom of the uterus can be touched round and hard, pressing the fetal head to have a floating ball feeling. Soft, wide and irregular fetal buttocks can be felt on the pubic symphysis. Fetal heart sounds are most clearly heard on the left or right side above the umbilicus. B-ultrasound showed that the fetal head was under the edge of the rib. Above the pubic symphysis are arms or feet.

3. Transverse diagnosis: the uterus is transverse oval, the fetal head touches the ventral side of the mother, and the pubic symphysis is empty. The fetal heart sounds on both sides of the navel are the clearest. B-ultrasound examination showed that the fetal head was on the abdomen side of the parturient.

32-34 weeks of pregnancy, the fetal position is still not right, so it is necessary to decide (1) the method of artificial outward migration of fetal position;

(2) Natural breech delivery;

(3) Direct caesarean section.

In the artificial outward migration of fetal position, drugs to relax uterus are usually given, which are carried out by experienced doctors, and the success rate is about 60%. However, if the pregnant woman has had a caesarean section before, it is not recommended to move the fetal position outward. In addition, only the amniotic fluid volume is moderate, the fetal back is on both sides, the maternal weight is moderate, and the fetal buttocks do not enter the deep pelvis, which is suitable for external rotation.

Improper fetal position * * * Production crisis: * * Improper production execution has the following crises: (1) Hypoxia at birth; (2) Cerebral hemorrhage; (3) Spinal injury; (four) hand nerve injury; (5) fracture; (6) Visceral injury; (7) Oral and throat injuries, etc.

Most mothers use caesarean section instead of breech delivery.

Most mothers choose caesarean section. In recent ten years, caesarean section has gradually replaced breech delivery in major hospitals. This is because many studies have found that the safety of caesarean section is higher than the uncertainty of natural delivery. This is not entirely the doctor's fault. Under the pressure of pregnant women and their families' concern for the fetus and the demand for zero errors, doctors and pregnant women jointly choose caesarean section.

If the fetal position is not correct, consult an expert: Conclusion Due to the above-mentioned crisis during delivery, expectant mothers with abnormal fetal position can choose to transfer fetal position or caesarean section. However, caesarean section is not completely safe, and complications such as blood loss and wound infection may occur. Therefore, when expectant mothers find that the fetal position is not correct, they must handle it carefully, consult experts and meet the challenge safely.