During the delivery, presentation abnormalities and rotation problems can arise. In certain cases, parturition in a hospital will become necessary. This is the case, for example, for a brow or facial presentation. A vaginal birth in a brow presentation is, in principle, impossible for a normal-sized foetus. A child that is born in a facial presentation often develops postpartum stridor with breathing problems due to overstretching and oedema of the larynx. In other cases, a correction of the abnormality is sometimes possible.
Procedure
- Have the woman push during five contractions whilst lying on the side, where the back of the child is also situated. This generally facilitates a flexed foetal position, and as a result, a more pronounced eccentric pole of the head arises.
- If the change in position alone is not successful enough, apply digital correction during a contraction.
- Do this by placing the vaginal fingers against the head of the foetus in front of the large fontanel.
- Flex the head during a contraction while the woman is pushing and rotate the small fontanel in the direction of the pubic symphysis.