η δύσκολη γεννήση από την ουρά

　　η εγκυμοσύνη3Η πιθανότητα να μην γίνει κεφαλόπτωση μετά από 0 εβδομάδες μπορεί να συνδέεται με τους παρακάτω παράγοντες:

　　1、παράγοντες ανάπτυξης του εμβρύου.Η συχνότητα των ασυνήθιστων γεννήσεων όπως η μικροencefalία, η ανωμαλία του εγκεφάλου και η υδροκεφαλία είναι πολύ υψηλότερη σε σχέση με τα κανονικά παιδιά.

　　2, restricted or excessive range of fetal movement space.Uterine malformations, pelvic narrowing, uterine or pelvic tumors blocking the pelvic cavity, relaxed abdominal wall in multiparous women, excessive amniotic fluid, etc., are prone to form breech presentation.

　　The most common complications of breech presentation during pregnancy include preterm birth, premature rupture of membranes, umbilical cord prolapse, prolonged labor, perineal laceration, uterine rupture, puerperal infection, and fetal intrauterine growth retardation. Breech presentation has a great impact on the prognosis of both the mother and the child and is considered to be in the high-risk category.

　　If the fetus is not delivered for a long time during childbirth, it is very harmful to the health of both the mother and the child. Therefore, it is necessary to do a good job of prenatal examination. If any abnormalities are found, they should be corrected and treated in a timely manner. The most effective preventive measure is to go to a regular hospital for prenatal examination according to regulations. Do pelvic measurement in the late pregnancy period so that the doctor can have a comprehensive understanding of the condition of both the mother and the child.

　　The main examination methods for this disease are as follows:

　　1, abdominal examination

　　The four-step palpation of the uterus is in a longitudinal ellipsoid shape, and the round and hard fetal head can be felt at the fundus, and there is a clear floating ball sensation when pressed. If it has not been connected, the fetal heart sound is most clear when listened to above the left or right umbilicus; if it has been connected, the fetal heart sound is most clear when listened to below the umbilicus.

　　2, rectal examination

　　If the abdominal examination cannot be definitely determined as a head or breech presentation, a rectal examination can be performed. If the pelvic cavity is empty and the round and hard fetal head cannot be felt, instead, a higher, soft, and irregularly shaped fetal buttocks can be felt, or the fetal feet can be felt, it can be diagnosed as breech presentation.

　　3, vaginal examination

　　If the anal examination cannot be determined, a vaginal examination is necessary. If the amniotic membrane has been broken, the fetus's anal, ischial tuberosity, and sacrum can be directly touched, and at this time, attention should be paid to distinguish from the facial features. If it is the fetal buttocks, the anus and the two ischial tuberosities can be touched in a straight line, and there is a contraction sensation when the finger is inserted into the anus, and the fetal meconium can be seen on the finger cover; if it is the face, the mouth and the two cheekbones protrude to form a triangle, and the alveolar ridge and mandible can be touched when the finger is inserted into the mouth.

　　4, ultrasound examination

　　B-ultrasound examination can not only determine breech presentation but also clarify whether the fetus has any malformations, and can measure the fetal head circumference and abdominal circumference to estimate the size of the fetus.

　　After the postpartum woman has surgery3-41 day, after anal exhaust, it indicates that the intestinal function begins to recover, and at this time, a small amount of liquid can be given.5～6After 1 day, the diet can be changed to semi-liquid food with less residue. Avoid eating chicken, ham, pigeon meat, and soups of various vegetables. Avoid greasy foods. Avoid eating dog meat, lamb, sparrow meat, sparrow eggs, bamboo shoots, scallions, pumpkins, beef, coriander, smoked fish, smoked meat, chili, chives, garlic sprouts, and mussels, etc.

　　Different treatment methods should be adopted at different stages of the disease.

　　1. During pregnancy: pregnancy30 weeks ago, many cases of breech presentation can turn themselves into vertex presentation without treatment. If pregnancy30 weeks later is still breech presentation, should be actively corrected. The commonly used correction methods are as follows.

　　1、Knee-chest position：Let the pregnant woman empty her bladder, loosen her belt, assume the knee-chest position,2～3time/d, each time15min, do1Weeks. This position can change the fetal center of gravity to help the fetal buttocks exit the pelvic cavity and turn into a vertex presentation.

　　2、External version of the fetus：If the above methods are ineffective and there is no nuchal cord around the neck, it can be reviewed after32-34Weeks perform the external version of the fetus. If the fetus is found to be active frequently and severely or the fetal heart rate is abnormal during the operation, the rotation should be stopped and returned to the original position, and closely observed until it returns to normal.

　　Second, the delivery period：In the early stage of labor, according to the age of the parturient, the number of deliveries, the type of pelvis, the size of the fetus, whether the fetus is alive and whether there are developmental abnormalities, the type of breech presentation and whether there are complications, etc., make a correct judgment to determine the mode of delivery.

　　1、Indications for cesarean section：Narrow pelvis, abnormal soft birth canal, fetal weight greater than3500g or the biparietal diameter of the fetal head is greater than9.5cm, the fetal head is in the supine position, incomplete breech presentation, primigravida with a history of difficult labor or neonatal injury, precious child, fetal distress, umbilical cord prolapse with good fetal heart rate, and cervix not fully dilated, should undergo cesarean section to end delivery.

　　2、Treatment of vaginal delivery

　　（1）The1Labor Process：The parturient should not stand and walk, should take a lateral position, and try to avoid the rupture of the amniotic membrane. Once the membrane breaks, the fetal heart rate should be immediately checked and checked for umbilical cord prolapse. If there is umbilical cord prolapse and the fetal heart rate is good and the cervix is not fully dilated, an emergency cesarean section should be performed to rescue the fetus immediately; if there is no umbilical cord prolapse, the fetal heart rate should continue to be closely monitored and the progress of labor should be observed.4-5cm, the fetal foot can be extruded outside the vagina, and the method of blocking the vulva can be adopted to fully dilate the cervix and vagina. During the process of blocking the vulva, the fetal heart rate should be monitored and attention should be paid to whether the cervix is fully dilated. If the cervix is fully dilated, it is easy to cause fetal distress and uterine rupture. When the cervix is fully dilated, preparations should be made for delivery and rescue of neonatal asphyxia.

　　（2）The2Labor Process：Before delivery, it is necessary to catheterize and empty the bladder, the perineum of the primigravida should be-Oblique incision.

　　（3）The3Labor Process：Active rescue of neonatal asphyxia. After the placenta is delivered, uterotonics should be used to prevent postpartum hemorrhage. Routine examination of the soft birth canal for lacerations. If there are lacerations, they should be sutured promptly and antibiotics should be administered to prevent infection.