What are the common fetal malpositions?

　　Breech presentation: during childbirth fetus Breech presentations with the buttocks first, or the feet or knees first, are divided into single-breech, mixed-breech and foot positions.

　　Transverse position: The transverse position in which the arms and shoulders are exposed during delivery.

　　Malformed head position: The above two fetal positions are common fetal malpositions. However, although some fetuses are also head-down, there are also malpositioned fetuses, which are called cephalic malpositions. like:

　　● Due to poor flexion of the fetal head, the fetal head becomes stretched forward with anterior fontanel, forehead, and face presentation;

　　● Occipito-posterior and occiputo-transverse positions due to malrotation of the fetal head;

　　● A high upright position with both poor rotation and poor flexion;

　　● The fetal head tilts unevenly from front to back, side to side, etc.

　　These are all fetal malpositions. These abnormal fetal positions create obstacles for pregnant mothers to give birth and can easily lead to dystocia.

　　Compound presentation: If the fetus's head or buttocks and upper limbs are prolapsed and enter the pelvis at the same time, it is a composite presentation. generally clinical It is more common when the head and hands enter the pelvis at the same time. If it is not corrected, natural childbirth will not be possible.

　　When is the best time to correct?

　　Breech presentation is the most common abnormal fetal position and the easiest to clinically diagnose. It accounts for 3% to 4% of the total number of full-term births. If it cannot be corrected before delivery, the risk to the mother and baby increases, especially to the baby. The perinatal mortality rate is 10 times that of the cephalic position. Therefore, it should be corrected to the head position during pregnancy. The specific timing is: 30 to 34 weeks of pregnancy, correct it in the knee-chest position, once a day in the morning and evening, 15 minutes each time, for 1 week; at the same time, laser irradiation or moxa sticks can be used to burn the Zhiyin point on the outside of the two little toes, once a day, 15 to 20 minutes each time, for 1 week; if the above two methods are not effective, after 34 weeks of pregnancy, the doctor will check whether it is feasible to invert from the outside at around 36 weeks.

　　What patients or their families can do

　　Chest-knee recumbent position: This method is generally used after 30 weeks of pregnancy when the fetal position is still breech or transverse. Pregnant women should do it before meals or 2 hours after eating, or before getting up in the morning and before going to bed at night. Beforehand, the bladder should be emptied and the belt should be untied. The pregnant woman should kneel on the bed with her knees slightly apart (shoulder width apart), with her knees at a right angle, her chest and shoulders on the bed, her head tilted to one side, and her hands hanging on both sides of the bed or on both sides of her head, forming a position where the buttocks are high and the head is wide and low. The bigger the difference between the two heights, the better, so that the top of the fetus' head reaches the mother's diaphragm, and the position of the fetus can be corrected by changing the center of gravity.

　　Moxibustion on the "Zhiyin point" with moxa roll: This method can be done at the same time with the chest and knees lying down. Pregnant women can do it by themselves, or with the help of family members, use lit moxa rolls to smoke to the Yin points (that is, the outer edges of the little toes on both sides), twice a day, for about 10 minutes each time.

　　Side decubitus position: This method can be used for the transverse or occipito-posterior position. When lying on your side, you can also gently touch the abdominal wall in the direction of lying on your side, twice a day for 15-20 minutes each time. You can also pay attention to your side-lying posture during sleep.