What is the cause of malposition of the fetus?

There are many reasons that may lead to malposition of the fetus, such as too much amniotic fluid after pregnancy, or the skin on the abdomen is too loose after pregnancy, or ectopic pregnancy and multiple fetuses. There is no need to be alarmed when the fetus is in malposition, because many women have more or less malposition of the fetus after pregnancy. There is no need to panic too much about this problem, it can be solved by active correction. Even if it is not corrected, a caesarean section during delivery will not cause dystocia.

Pregnant women should go to the hospital regularly for pregnancy check-ups. The doctor will use a four-step method to determine whether the fetal position is abnormal, as shown in the figure below. If it is a breech or transverse position, it should be able to turn back to normal by itself before 30 weeks of pregnancy. However, if it cannot turn back to normal by itself after 30 weeks, it should be corrected. The examiner places both hands on the fundus of the uterus, touches the fundus, and estimates whether the size of the fetus is consistent with the gestational age; then the examiner gently pushes with the fingertips of both hands against each other alternately to determine the fetal part of the fundus of the uterus. If it is the fetal head, it will be hard and have a floating ball-like feeling. If it is the buttocks, it will be large, soft and slightly irregular in shape.

The examiner places his hands on the left and right sides of the abdomen, with one hand fixing it and the other hand gently pressing deeply to check, alternating between the two hands. The flat and full part that is touched is the fetal back, and the direction of the fetal back is determined. The uneven parts are the fetal limbs, and sometimes you can feel the fetal limbs moving. The examiner separates the thumb of his right hand from the other four fingers, places it above the phalangeal joint to hold the fetal presenting part, determines whether the presenting part is the fetal head or buttocks, and pushes it left and right to determine whether it is connected. If the presenting part is still floating, it means it has not yet connected to the pelvis; if it has been connected, the presenting part of the fetus cannot be pushed.

It should be noted that there is a type of malposition of the fetus called breech presentation. Women with this type of malposition of the fetus are at higher risk during childbirth, so this type of malposition of the fetus requires early preparation for a caesarean section. The correction of fetal malposition requires a certain time frame. Generally speaking, after the 32nd week of pregnancy, the fetal malposition is basically confirmed, and this is the best time to correct it.