Fetal presentation refers to the positioning of foetus in the womb, there are many recorded presentations of foetus but the best presentation for normal delivery is head leading the way
Some Abnormal Presentations
Occiput posterior presentation
In occiput posterior presentation (also called sunny-side up), the fetus is head first but is facing up (toward the mother’s abdomen). It is the most common abnormal position or presentation.
When a fetus faces up, the neck is often straightened rather than bent, and the head requires more space to pass through the birth canal. Delivery by a vacuum extractor or forceps or cesarean delivery may be necessary.
The buttocks or sometimes the feet present first. Breech presentation occurs in 3 to 4% of full-term deliveries. It is the second most common type of abnormal presentation.
When delivered vaginally, babies that present buttocks first are more likely to be injured than those that present head first. Such injuries may occur before, during, or after birth. The baby may even die. Complications are less likely when breech presentation is detected before labor or delivery.
Breech presentation is more likely to occur in the following circumstances:
- Labour starts too soon (preterm labor).
- The uterus is abnormally shaped or contains abnormal growths such as fibroids.
- The foetus has a birth defect.
In face presentation, the neck arches back so that the face presents first.
In brow presentation, the neck is moderately arched so that the brow presents first.
Shoulder Dystocia: Shoulder dystocia occurs when one shoulder of the fetus lodges against the woman’s pubic bone, and the baby is therefore caught in the birth canal.
The fetus is positioned normally (head first) for delivery, but the fetus’s shoulder becomes lodged against the woman’s pubic bone as the fetus’s head comes out. Consequently, the head is pulled back tightly against the vaginal opening. The baby cannot breathe because the chest and umbilical cord are compressed by the birth canal. As a result, oxygen levels in the baby’s blood decrease.
Shoulder dystocia is not common, but it is more common when any of the following is present:
- A large foetus is present.
- Labour is difficult, long, or rapid.
- A vacuum extractor or forceps is used because the fetus’s head has not fully moved down (descended) in the pelvis.
- Women are obese.
- Women have diabetes.
- Women have had a previous baby with shoulder dystocia.
Why caesarian section in abnormal fetal presentation
As scarry as it appears to many, it’s still remained one of the safest delivery options globally because of the safety rate for the mother and the baby. Cases are abounded of people that voluntarily opted for this method during delivery, not because of their affluence nor birth problem but consider the option best for them.
Here are reasons why doctor’s counsel a family to consider caesarian section:
- To ensure the safety of the mother and foetus
- To avoid congenital deformity on either parent
- For multiple delivery (twin or triplet)
- Previous CS history
- Abnormal fetal presentation
- Pelvic width to the head size of the baby
- Congenital deformities among others