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Childbirth Complications

Childbirth Complications

Abnormal Presentation continued...

Abnormal presentations increase a woman's risk for injuries to the uterus or birth canal, and for abnormal labor. Breech babies are at risk of injury and a prolapsed umbilical cord. Transverse lie is the most serious abnormal presentation, and it can lead to injury of the uterus (ruptured uterus) as well as fetal injury.

Your doctor will determine the presentation and position of the fetus with a physical examination. Sometimes a sonogram helps in determining the fetus' position. When a baby is in the breech position before the last six weeks to eight weeks of pregnancy, the odds are still good that the baby will flip. However, the bigger the baby gets and the closer you get to the due date, the less room there is to maneuver. Doctors estimate that about 90% of fetuses who are in a breech presentation before 28 weeks will have turned by 37 weeks, and over 90% of babies who are breech after 37 weeks will most likely stay that way.

Umbilical Cord Prolapse

The umbilical cord is your baby's lifeline. Oxygen and other nutrients are passed from your system to your baby, through the placenta and the umbilical cord. Sometimes before or during labor, the umbilical cord can slip through the cervix, preceding the baby into the birth canal. It may even protrude from the vagina. This is dangerous because the umbilical cord can get blocked and stop blood flow through the cord. You will probably feel the cord in the birth canal and may see it if it protrudes from your vagina. This is an emergency situation. Call an ambulance to get you to the hospital.

Umbilical Cord Compression

Because the fetus moves a lot inside the uterus, the umbilical cord can get wrapped and unwrapped around the baby many times throughout the pregnancy. While there are "cord accidents" in which the cord gets twisted around and harms the baby, this is extremely rare and usually can't be prevented.

Sometimes the umbilical cord gets stretched and compressed during labor, leading to a brief decrease in the flow of blood within it. This can cause sudden, short drops in the fetal heart rate, called variable decelerations, which are usually picked up by monitors during labor. Cord compression happens in about one in 10 deliveries. In most cases, these changes are of no major concern and most babies quickly pass through this stage and the birth proceeds normally. But a cesarean section may be necessary if the heart rate worsens or the fetus shows other signs of distress, such as decrease of fetal blood pH or passing of the baby's first stool (meconium).

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