Gluteal presentation refers to the position where the fetus is located with the buttocks down, and the head upward. This occurs in 3-4% of pregnancies and is very often observed with preterm labor and twins. It is considered one of the most difficult presentations of the fetus.
There are three types of breech presentation:
- purely gluteal presentation, when the buttocks look down, the legs are straightened towards the head;
- full - the child sits cross-legged;
- foot - when one or both feet are directed down.
Most often there is a pure breech presentation and a mixed breech presentation. In these cases, the probability of prolapse of the umbilical cord increases many times, since the cervix does not close with the legs or the buttocks of the child, and, therefore, there are no obstacles for the umbilical cord to fall into the vagina.
Breech presentation complicates childbirth. The legs and body of the child come out first, and the head can pinch the umbilical cord, reducing the flow of oxygen into the placenta. Another risk factor is that not always the cervix is opened enough for the birth of the head. That is why there is a risk of birth injury, or spinal injury.
Gluteal presentation of the fetus - reasons:
- polyhydramnios and consequently increased fetal activity;
- presence of a narrow pelvis, abnormal location of the placenta, fetal development abnormalities;
- manifestation of malnutrition, abnormal development of the uterus;
- a decrease in the tone of the uterus.
Doctors can determine the position of the fetus in the last month when examined, if there are doubts, a sinogram will help. When the youngster is in the breech position, he may still change his mind and take the right position just before the birth.
Starting at week 37, the doctor will still try to manually give the baby the correct position, turning it hard, but with gentle pressure on the head and thighs. With a successful procedure, the chance of a vaginal birth increases, but the child can still change its position.
What can I do by myself?
There are simple tricks that many mothers have successfully used to make the kid turn over and take the headline. Can:
- Use a flashlight and shine it on the bottom of the abdomen for the baby to turn his head toward the light;
- bring the source of music to the bottom of the abdomen;
- to do exercises.
Gymnastics with an identified pelvic presentation
Can be performed starting from 34-35 weeks.
- A pregnant woman should lie on a hard surface. Every 10 minutes you need to turn on the right, then on the left side for 3-4 sets 3 times a day for a week. Do before eating.
- Take the position on the floor in such a way that the pelvis rises 30-40 cm higher than the shoulders. It is better to put a pillow under the basin. Shoulders, pelvis and knees should be in one straight line. Many recognized the effectiveness of this particular exercise. From the first time, success is possible.
- To perform the "Pose Animal" exercise you need to get on all fours, resting all the limbs on the floor, the weight should be transferred to the elbow joint. We relax the abdomen, chest and crotch.
So the baby is easier to move around in the uterus. Exercise brings a double benefit, will help to take the head previa and reduce the tone of the uterus.
If the child has not accepted the correct position by the day of childbirth, then the doctor can make a decision either in favor of natural childbirth, or carrying out an operation.
In any case, you need to fully trust the doctors, because they reasonably assess the situation and possible risks. More often vaginal births are carried out for women with a wide basin, with a child weighing not more than 3.5 kg. But still cases with caesarean section with breech presentation are much greater.