This is normally when the baby who enters the birth canal
with his head abnormally enters the hips or legs. In other words, while the
baby's head should be down in the womb, if the bottom is down, it is called a
breech baby. Infants, which appear to be inverted during the first months of
pregnancy and in the middle months, often return to the last month and come to
a straight position. Breech baby is observed in 3-4% of pregnant women whose
birth time is approaching.
Causes,
risk factors:
- Prematurity is the most important risk factor.
- Polar placentation (Placenta previa or placement in the
fundus)
- Oligohydramnios
- Polyhydramnios
- Myotonic dystrophy
- Congenital anomalies (Hydrocephalus, anencephaly)
- Chromosomal anomalies (trisomy 21, 28, 13)
- Twin, triplet pregnancy
- Grand multiparite (having more than 5 births)
- Having had breech births before
- Uterine anomalies
- Pelvic tumors
This can be understood in ultrasound performed before birth.
In the past, the method called "external cephalic version" was used
to turn upside down the breech baby before birth, but it is not applied today
because there is a high risk of harm to the baby.
Pregnancies that are breech babies can be delivered normally
or vaginally according to various criteria. The following criteria may not
always be sufficient, as with every birth, the mother's examination and
ultrasound evaluation determine the decision. Nowadays, breech baby is mostly
delivered by cesarean section, sometimes when no risk is found, especially in
women who have given birth before, normal delivery is performed.
Normal
(vaginal) delivery is recommended when:
In pure breech type, those over 34 weeks of gestation, if the
estimated birth weight is between 2000-3500grams, if there is no infantile congenital
disease, if the labor is advanced, the mother's pelvis is not narrow.
Various maneuvers such as breech births Pinard maneuver,
Mauriceau maneuver, Modified Praque maneuver can be applied.
Cesarean
section is recommended when:
Full breech arrival, foot arrival, preterm birth, large baby,
severe IUGR, hyperextension of the head, pelvic stenosis
Breech baby
complications, risks:
Some risks and dangers that increase compared to normal
pregnancies if the baby is upside down are listed below, these dangers do not
occur in all breech babies, there is only an increased risk.
- Cord sagging
- Difficult birth (Dystocia)
- Increase in cesarean rate
- Laceration in the birth canal
- Uterine atony
- Humerus, clavicle, femur fracture in the fetus
- Brachial plexus injury
Testicular damage to the fetus, brain damage, intracranial
hemorrhage, asphyxia
How to
understand if the baby is upside down during pregnancy?
It is not possible for the expectant mother to understand
this. Ultrasound is sufficient to understand the baby's breech or head below.
Although it does not give clear information as much as an ultrasound
examination, it can sometimes be understood with a manual examination.
How does
the baby turn upside down?
A significant portion of the babies who are upside down in
the womb during pregnancy will recover spontaneously in the following months.
There is nothing the mother or doctor can do to help the baby recover, the baby
can turn by itself. It is inconvenient to apply pressure to the womb and to make
dangerous movements to correct the baby, that is, to turn upside down. As the
baby grows larger as the months of gestation progress, the area in the uterus
narrows and the chance of the baby to return decreases, however, even in the
last days of pregnancy, there may be babies returning.
What to do
if the baby is upside down?
If there is no other problem during pregnancy, there is
nothing that can be done except to continue the pregnancy follow-up regularly
and to discuss with your doctor about the way of birth according to the baby's
turning.
When is
breech babies born?
Breech baby does not change the birth time. Breech babies are
not more likely to be born early or late, and the average delivery time is the
same as that of flat babies. Breech babies are also born with a normal birth or
cesarean between 37-40 weeks. Delivery before 37 weeks is called preterm birth.
Although the day passes (timeout) is over the course of 41-42 weeks, it is said
that the pains do not start, in this case the applications in the same normal
babies are valid, but if breech babies pass the day, they are more likely to be
delivered by cesarean surgery.
-GYNECOLOGICAL EXAMINATION IN PREGNANCY
-USE OF CALCIUM DRUG IN PREGNANCY
-CARBONHYDRATE, PROTEIN AND OIL CONSUMPTION IN PREGNANCY
