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Abnormal Fetal Presentations

 

The 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.

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