Which direction does the right occipital anterior fetus face?

Common abnormal fetal positions during pregnancy include breech presentation, transverse presentation, and cephalic presentation. Abnormal fetal position during childbirth often poses a great threat to the mother and the fetus, and is one of the main causes of dystocia and perinatal death. Therefore, if abnormal fetal position is found in the early stage, timely correction can reduce the incidence of dystocia in pregnant women, and thus reduce the perinatal mortality rate of pregnant women and fetuses.

Reduction of single breech presentation (simple breech presentation with only breech presentation first)

The baby's body is folded in two at the buttocks, with both feet raised above the head. During childbirth, the buttocks come out first. This method of delivery is the safest among buttocks births, because as long as the cervix is ​​open large enough to allow the buttocks to come out, there is no need to worry about the head not coming out.

Reposition the breech (buttocks and feet go out first)

The baby is sitting cross-legged, with the buttocks and one foot coming out first. Although this is also a safe production method, sometimes only one foot can go out first, which is the incomplete foot position introduced below.

Reset incomplete foot position (only one foot can be moved out first)

This type of situation is different from the previous two situations in that it is easy to break the amniotic fluid prematurely, and therefore the fetal umbilical cord sometimes slips out of the cervical opening.

Once this happens, the umbilical cord between the endometrium and the baby will be compressed, which will seriously endanger the life of the baby. Moreover, with this type of delivery method, even if the buttocks come out first, the cervix cannot open fully, causing the baby's head to be stuck in the cervix and difficult to come out, which may lead to dystocia.

Reset the whole foot position (two feet out first)

Compared with the previous method of delivery, this type of delivery makes the umbilical cord of the fetus more likely to slip off, accelerates the deterioration of the baby's blood circulation system, and is the most difficult type of delivery among transverse fetal positions.

How to reduce the fetal transverse position?

In terms of obstetric treatment, if the fetus is still in the transverse position at the ninth month (36 weeks) of pregnancy, it is considered a confirmed diagnosis. However, there is still a chance that the fetal position will change before delivery for a very small number of pregnant women. However, generally speaking, when the fetus is still in the transverse position - "breech position" - at 32-34 weeks of pregnancy, it should be decided to (1) perform artificial external rotation of the fetal position; (2) perform natural breech delivery; (3) perform immediate cesarean section.

When performing artificial external foetal rotation, uterine relaxation drugs are usually given, and experienced doctors have a success rate of about 60%. However, it is not recommended for pregnant women who have had a cesarean section before. In addition, the external foetal rotation must be performed under the following conditions: the amniotic fluid flow must be moderate, the fetus's back is preferably on both sides, the pregnant woman's weight is moderate, and the fetus's buttocks have not entered the shallow layer of the pelvis.

Right occipital anterior position

How to detect and correct abnormal fetal position in production

Specific method: Pregnant women should go to the hospital for prenatal check-ups in time. The doctor will use a four-step technique to determine whether the fetal position is abnormal.

If it is a breech or transverse position, it should be able to turn automatically and become normal before 30 weeks of pregnancy. However, if it cannot be automatically reset after 30 weeks, it should be corrected in many ways.

1. Chest-knee position: You should urinate before doing it, loosen your belt, and take 4.8 mg of salbutamol 30 minutes before, if necessary, to increase the success rate. Perform it appropriately under the doctor's guidance, 15 minutes each time, once in the morning and once in the evening, and return to the doctor after one week.

2. Side-lying rotation method: When the pregnant woman goes to bed at night, she lies on the side of the fetus's body, and uses the force to make the fetal head move into the pelvis.

3. Moxibustion Zhiyin acupoint: once a day, each time for 15 minutes, and follow up after one week.

4. Improved external version: suitable for 32-36 weeks of pregnancy.

The method is to take 4.8 mg of salbutamol 30 minutes before the operation to relax the uterine smooth muscle, and then perform abdominal vaginal double inversion. After the inversion is successful, use a abdominal belt to fix it in all directions. Surgical treatment should be performed with caution, and the scope of application and contraindications should be strictly selected.