How to judge the position of fetal presentation? Judgment of fetal presentation and fetal orientation: mainly through four-step palpation to understand whether there is any connection between fetal delivery type, fetal presentation, fetal orientation and fetal presentation; When doing the first three steps, the inspector should face the pregnant woman, and when doing the fourth step, the inspector should face the foot end of the pregnant woman. Step 1: the examiner puts his hand on the bottom of the uterus and touches the height of the bottom of the uterus to estimate whether the fetal size is consistent with the number of weeks of pregnancy; Then gently push the two fingers alternately to judge the fetal position at the bottom of the uterus. If it's a fetal head, it's hard and feels like a floating ball. If it's a fetal hip, it's big and soft with a slightly irregular shape.
Step 2 Operation: The inspector puts his hands on the left and right sides of the abdomen, one hand is fixed, the other hand is lightly pressed and deeply pressed, and his hands alternate. The flat and full part at the beginning of the medical education network is the fetal back, which determines the orientation of the fetal back. The uneven part is the fetal limb, and sometimes the fetal limb movement can be felt. The third operation: the inspector separates the thumb of the right hand from the other four fingers, holds the fetal presentation part above the pubic symphysis, judges whether the fetal presentation part is the fetal head or the fetal buttock, and pushes it left and right to determine whether it is connected. If the first exposed part is still floating, it means that it has not been connected to the basin; If it is connected, the exposed part of the fetus cannot be pushed.
The fourth step is manipulation: the examiner's left and right hands are placed on both sides of the fetal presentation and pressed down in the direction of pelvic entrance; Further diagnose the degree of fetal presentation and fetal presentation into the basin. The position where the fetus first enters the pelvic entrance is called fetal presentation, and the way that the indication point of fetal presentation is in line with the maternal pelvis is called fetal orientation. We can determine the fetal presentation and fetal position by abdominal examination, abdominal palpation, anal digital examination and B-ultrasound examination, and we can also know the fetal presentation and fetal position by four-part palpation. The best mode of production is head presentation, while hip presentation and shoulder presentation are both dystocia.
What do you mean the fetus comes first? The first time the fetus appears, the head is below, and the normal fetal position means the head is below. When the head is below, the baby can give birth naturally through the mother's birth canal, and the head below is the normal fetal position. Some abnormal fetal positions, such as breech position at the bottom, and some horizontal positions below the baby's shoulders. These are abnormal fetal positions. These abnormal fetal positions are difficult to give birth naturally, and many of them need cesarean section, so the normal fetal position should be exposed first. The specific situation needs to be examined in a regular hospital and judged by a professional doctor.
The presentation of the head is a normal fetal position, indicating that the baby's head is below, and it can be delivered in the third trimester. At this time, after 28 weeks of pregnancy, the position of the fetus in the uterus will change, and there will be fetal movement, such as turning over, so the fetus will change. Generally, in the third trimester, with the growth of the fetus, the uterine space will become smaller and the fetal position will tend to be stable. Fetal outcrop refers to the normal position of fetal head, that is, the fetal head is delivered from the mother first, which is a common fetal position and the best fetal position for pregnant mothers to give birth naturally. However, it should be noted that the fetal position may change during the whole pregnancy, so the final B-ultrasound shall prevail. If it is not the first position, you can do some gymnastics or massage.
At present, there are two main methods for fetal position examination, one is ultrasound examination and the other is four-step palpation. The method of B-ultrasound examination is intuitive and clear. The four-step palpation rule requires experienced doctors to look at the fetal head and determine the position of the fetal buttocks by touching. Four-step palpation is the most commonly used method for prenatal examination, starting from the 24th week of pregnancy. Through the four-step palpation method, we can determine the position and size of the fetus, whether the size of the uterus is consistent with the gestational age, determine the delivery mode, fetal presentation and fetal position of the fetus, and estimate the amniotic fluid volume. 1. The examiner puts his hand on the fundus, measures the fundus height, and estimates whether the fetal size is consistent with the gestational age. Then gently push the two fingers alternately to judge the position of the fetus at the bottom of the uterus.
If it is a fetal head, it is hard, round and floating. If it is a fetal hip, it is soft, wide and slightly irregular in shape. 2. The inspector puts his hands on the left and right sides of the abdomen, one hand is fixed, and the other hand is lightly pressed and deeply pressed, alternating up and down. The flat and full part is the tire back, which determines whether the tire back is forward, sideways or backward. Touching the deformable uneven part is the fetal limb, and sometimes you can feel the fetal limb moving. 3. The inspector will separate the thumb of the right hand from the other four fingers, hold the fetal presentation above the pubic symphysis, further find out whether it is the fetal head or the fetal buttock, and then push it left and right to judge whether it is connected. If the fetal presentation can still move left and right, it means that the basin has not been connected. If it's connected, the fetus can't be pushed first.