Abnormal Fetal Presentations

baby's arm and stethoscopeThe position of the baby in the uterus is referred to as its “presentation.” It is important that obstetricians or midwives monitor the baby’s presentation as pregnancy approaches term to determine whether it is in the correct position for vaginal delivery, or whether other measures should be taken.

The best position for delivery is called “cephalic,” which means the baby facing the mother’s back, head down with chin tucked in, with the back of the head ready to move into the pelvis. Usually, a fetus moves into this position during the last couple of months of pregnancy.

However, there are other positions that can cause difficulties and require intervention by the health care provider.

The baby might be head down, but facing forward. This presentation is called “cephalic” or “occiput posterior” (OP) and is correlated with prolonged labor.

A “transverse” lie occurs with the baby is sideways in the uterus so that its shoulders will enter the pelvis before its head.

“Breech” position describes a presentation in which the baby’s buttocks lead the body into the birth canal. In a “Frank Breech,” the baby’s knees are extended; in a “Complete Breech,” its knees are bent. A “Footling Breech” occurs when the baby’s foot, or feet, are aimed at the birth canal. Breech positions greatly increase the chances of the umbilical cord becoming looped or entangled, thus blocking the flow of blood to the fetus.

Sometimes, unfavorable presentations resolve spontaneously. The baby turn into the correct position before delivery. It requires experience and training for a health care provider to know how long to wait to see if this happens.

Obstetricians and midwives sometimes attempt to resolve an unfavorable presentation manually, by putting their hands on the mother’s abdomen and trying to shift the baby to a cephalic presentation. This procedure, called “cephalic version,” is done with ultrasound guidance and requires considerable experience and skill.

Other times, cesarean section is the only safe option.

Therefore, it is critical that medical staff be adequately trained to recognize unfavorable presentations and respond appropriately. Otherwise, the baby or the mother are at risk of significant injury.

A baby might be injured traumatically by the forces of labor and delivery, or the umbilical cord might be blocked causing Hypoxic Ischemic Encephalopathy and cerebral palsy. A mother might experience uterine rupture and post-partum hemorrhage.

If your baby or loved one suffered a birth injury as a result of a breech birth or other unfavorable presentation, you may be able to take action. Our Houston birth injury attorneys at Hampton & King take this type of situation very seriously and we want to make sure mothers and families of babies with birth injuries understand their options. We work on your behalf to not only seek compensation and justice, but help prevent this type of negligence from happening to someone else in the future. Call us today and learn what we may be able to do to help you.

Related Stories: