Introduction
In the final weeks of your pregnancy, your baby usually moves into a head-down (vertex) position to get ready for birth. As a normal delivery proceeds through the stages of labor, the baby tucks in the chin and turns to face your back. In this position, the back of your baby's head starts to show (crown) first. Sometimes your baby may be in a different, abnormal position just before birth. These positions are called malpositions or malpresentations. Giving birth can be more difficult if your baby is in an abnormal position.
Your health care provider can diagnose an abnormal fetal position during a physical exam as your due date approaches. An abnormal fetal position may be found by feeling your belly and by doing an internal (pelvic) exam. A sound wave
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There are five main abnormal fetal positions:
Occiput posterior presentation. This is the most common abnormal fetal position. It is sometimes called the "sunny-side up" position because your baby's face points toward your front instead of your back.
Breech presentation. This is the next most common abnormal position. In this position, your baby's bottom or feet are in position to come out first.
A face or brow presentation. In this position, your baby is head down but the face or front of the head crowns first. This is not common.
A compound presentation. In this position, your baby's hand or leg comes out along with the head or bottom. This is not common.
A transverse presentation. In this position, your baby is lying sideways across your birth canal. Your baby's shoulder may come out first.
What causes an abnormal fetal position?
In many cases, there is no known cause for an abnormal fetal position. You may be at higher risk of having a baby in an abnormal fetal position if:
You have an abnormally shaped womb (uterus) or pelvis.
You have growths in your uterus, such as fibroids.
Your placenta is large or in an abnormal position.
You are having twins or
Fetal distress or birth asphyxia means that there has been a change in organ systems due to the lack of oxygen in the body. Breech delivery is when the babies buttock comes out first instead of the head during birth. “Meconium is when the baby’s first stool is passed during pregnancy into the amniotic fluid.” If the baby is born with nuchal cord this means that the umbilical cord was around the baby’s neck (http://www.lpch.org).
On today’s evaluation, she is 19 weeks and the fetal measurements overall are concordant. The long bone measurements are within one week of her dates. The amniotic fluid volume is normal, and the cervix is long and closed. A complete fetal anatomical survey was performed and a significant amount of ventriculomegaly/hydrocephalous was identified but no other major malformations were noted at this time, though due to the
On ultrasound, there is a live fetus in breech presentation. Fetal biometry is symmetric and consistent with dates. A detailed anatomic survey was overall unremarkable but we were unable to adequately obtain fetal cardiac views in order to complete the echocardiogram. Both myself and the sonographer scanned and unfortunately the fetus remained in the spine up position after an extended amount of
The condition occurs when the anus does not develop normally in the womb. However, no one knows just why this happens. Often, babies born with this condition have other birth defects.
Congenital abnormalities occur during a fetus’s development before birth. In the United States, about three to four percent of babies are born with some sort of congenital abnormality. Spina bifida is the most common congenital abnormality, occurring in about one in every one thousand births. Spina bifida happens when the spinal bones do not close properly during formation. Spina bifida can be seen in a newborn by a small sac located on the spine. Surgery must be done within the first few days of the infant’s life in order to remove the sac. The sac contains spinal fluid and damaged nerves, but little can be done to repair the damaged nerves.
We feel that the best position for baby is facing in, with their thighs supported. I know of no babies who have been damaged by being carried in a legs-dangling
There are other methods of detecting spina bifida, but sonography is the most sensitive, especially in terms of closed spina bifida. For increased accuracy, the fetal spine should be evaluated in all three scan planes. If spinal defects are suspected, the fetal head should also be evaluated. Without the use of sonography, the parents of the twins from the case study would not be prepared for a different lifestyle. It also allowed the doctors to be prepared for the surgeries that would be necessary, which would not have been possible if it were not for
This can place the baby in a breech or posterior position, which affects the ability to have a natural childbirth and can lead to a medical intervention such as a C-section.
On ultrasound evaluation today a single living fetus is identified currently in cephalic presentation with a 3-vessel cord and an anterior placenta. Fetal biometry today is consistent with an EFW of 1386 g, which equates to the 20%ile for gestational age and a symmetric appearing growth pattern. The amniotic fluid volume is within
On ultrasound there is a live fetus whose biometry is consistent with 20 weeks 5 days. A detailed anatomic survey was unremarkable but spine and RVOT were suboptimal. The placenta is posterior. Abdominal cervical length is reassuring.
Occurring after the baby's head has passed through the birth canal, shoulder dystocia is a condition in which one or both of the baby's shoulders get stuck behind the mother's pelvis. This can potentially break the baby's arm or collarbone. Babies can also die or suffer brain damage when the dystocia restricts cranial blood flow. To prevent shoulder dystocia, consider a cesarean section for multiple births and avoid having your labor induced, if possible.
Ultrasound today shows a singleton live intrauterine pregnancy in cephalic presentation. Growth parameters show appropriate growth. Fetal anatomy all appears normal within resolution of the scan. BPP is 8/8. Doppler flow studies of the umbilical artery are normal. Amniotic fluid volume is in the normal range. The placenta on today’s scan is grade 2. We did not see any evidence of placenta abruption or previa.
The baby’s head should be in neutral position so that neck is not extended which can contribute to tongue protrusion.
On ultrasound, there is a live fetus in cephalic presentation Fetal biometry is consistent with 20 weeks 3 days giving a new due date of 07/31/17. We attempted an anatomic survey but it was somewhat suboptimal due to fetal position and maternal body habitus. The spine, heart, and kidneys were suboptimal. The placenta is anterior.
With respect to fetal anatomy overall biometry is consistent with dates, and no fetal anatomic abnormalities are identified within the resolution of today’s study. No minor markers for fetal aneuploidy are seen. We were able to complete the anatomic survey today. Cervical