By the 36th week of pregnancy, the baby takes the position that will remain until the moment of birth. That part of the baby's body that will be turned into the mother's pelvic cavity is called the presenting. In 97% of cases, this is the head, and the most favorable of the head presentations is occipital presentation, when the chin of the fetus is close to the chest. But in 2.5% of pregnancies, a breech presentation or, even more rarely, a transverse or oblique position may persist. In such cases, to avoid caesarean section resort to obstetric rotation of the fetus.

External rotation of the fetus: indications and contraindications

With the pelvic position of the child before delivery, an external obstetric turn fetus. This series of manipulations, which is recognized by obstetricians around the world, allows you to reduce the frequency of delivery by caesarean section.

Previously, with insufficient development of technical means, it was difficult to control the effectiveness and safety of manipulation. Currently, everything is carried out under the control of ultrasound and CTG, so the risk of complications is much lower than after a caesarean section.

The procedure is performed at 35-36 weeks. The probability of maintaining head presentation after it reaches 60%. When performed in more late dates efficiency is much lower. Mandatory conditions are:

• good fetal mobility;
• pliable abdominal wall;
• pelvis of a pregnant woman of normal size;
• general good condition of mother and fetus.

There is no need to perform obstetric rotation when breech presentation if delivery is planned by caesarean section. Manipulation is contraindicated in the following cases:

• had a history premature birth or antenatal death;
• operated uterus;
• pregnancy was complicated by toxicosis, preeclampsia or bleeding;
• multiple pregnancy;
• oligohydramnios and polyhydramnios;
• large fruit;
• anomalies in the development of the uterus,.

Technique for performing an obstetric turn

Obstetric rotation is performed in a hospital setting, where it is possible, if indicated, to transfer a woman to a birth unit or deploy an operating room.

• Before starting, an ultrasound scan is mandatory to determine the position of the fetus, the amount of water and the location of the placenta, and CTG to assess the condition of the fetus.
• A woman is given an enema, asked to empty bladder or urinate with a catheter.
• Be sure to introduce tocolytics, which will prevent the development of uterine tone.
• The pregnant woman takes a supine position on the couch.
• The doctor is located nearby, facing the pregnant woman. He places one hand on the pelvic end, and the other on the head of the fetus.
• The pelvis is shifted upward very carefully, at the same time pressure is applied to the head. The fetus rotates towards its abdominal wall.

Obstetric rotation of the fetus may have consequences in the form of recurrence of breech presentation. To avoid this, it is recommended to apply a bandage at the level of the navel or slightly below it. It can be an elastic 10 cm tape. It will give the uterus a more elongated vertical shape. If the bandage is removed, the child can assume a transverse position.

Many fear trauma to the fetus when performing a turn. If there are no contraindications, the procedure is quite safe. The child cannot get injured, all manipulations are softened by amniotic fluid.

If during the manipulation a deterioration in the condition of the mother or child is noticed, it is immediately stopped. The second attempt is carried out only under the condition of complete well-being.

After turning, ultrasound is done again, CTG is recorded to assess the child's condition. After 1-2 days, it is recommended to come back for examination and assessment of the condition of the fetus. If everything went well, then childbirth can go through the natural birth canal. Otherwise, a caesarean section will be offered.

Obstetric rotation can be complicated by twisting or compression of the umbilical cord and the development of fetal hypoxia. Continuous monitoring allows you to monitor the child's condition and take the necessary measures. Sometimes the water may break or labor may develop. This is not critical, since the manipulation is performed at 36 weeks, when there is no longer a risk to the fetus.

Rotation of the fetus on the leg during childbirth: indications and technique

Diagnostic errors can lead to the development of the transverse position of the fetus during childbirth. To correct the situation, the obstetric rotation of the fetus on the leg will help.

The transverse position is not the only indication, besides it, manipulation is carried out in cases of prolapse of small parts of the body and the umbilical cord during the presentation of the head. By themselves, incorrect head insertions (posterior parietal, frontal, facial) are not recognized as indications for manipulation.

This type of assistance is carried out with the opening of the pharynx by 10 cm and the preserved mobility of the fetal head and the whole fetal bladder. If a running transverse position has developed, the procedure is not resorted to. The head of the fetus must match the size of the mother's pelvis, otherwise everything loses its meaning. With the onset of rupture of the uterus, the rotation is not carried out.

In modern conditions, the course of the operation is monitored with the help of ultrasound and CTG apparatus.

• The woman in labor is given anesthesia, urine is released through a catheter.
• The external genitalia are thoroughly disinfected.
• The hand is smeared with Vaseline.
• The doctor usually inserts the right hand into the vagina, but some practice matching the position of the fetus: if the head is turned to the left, then the left hand, if to the right - the same name.
• When the uterine os is reached, the second hand is placed on the stomach. The waters open and penetration into the uterine cavity occurs.
• To find the legs by touch, they determine the side of the child, move from the armpit in the wrong buttocks. At the same time, the pelvis of the fetus is held with the outer hand and slowly shifted towards it.
• The fetal leg is grasped by the shin, clasping it with four fingers, and placing the large one under the knee. Alternative option: a grip is made on the foot, holding it with the thumb from below.
• The outer hand is transferred to the head area, the inner one is sipped and the leg is lowered into the vagina. Immediately after this, the fetus is removed.

During the procedure, complications may occur in the form of prolapse of the umbilical cord loops. The action continues carefully, trying not to press it. If by mistake the handle is captured and withdrawn, then it is taken to the side with a bandage loop, re-enters the birth canal, finds the leg and rotates.

If all mandatory conditions to perform a turn, uterine rupture is possible. To avoid it, you need to follow all the instructions exactly.

Yulia Shevchenko, obstetrician-gynecologist, specially for the site

Useful video

Most babies turn their heads towards the exit of the uterus, which is known as cephalic presentation. But if your baby has not done this, then in 90% of cases this means that he is preparing to come out of the womb forward with his buttocks or legs. For such children, a gynecologist or obstetrician may try to “help” roll over with the help of an external obstetrical rotation fetus.

By the time of birth, about 97% of babies are in the cephalic position, and only 2.5% of babies remain in the breech position. Where did the other 0.5% go, you ask? This value falls on such rare cases when the child becomes shoulders or arms towards the exit from the uterus, that is, it takes a transverse presentation.

Breech presentation is divided into several types: foot (when one or both legs are located first in relation to the exit from the uterus), gluteal (when the buttocks of the child are facing the exit from the uterus) or knee (when legs bent at the knees are directed towards the exit from the uterus).

By the beginning of the third trimester of your pregnancy, your gynecologist, by probing through the abdomen for the placement of the baby's head, his back and lower torso, will already be able to tell which position your baby has taken. About ¼ of babies are in a breech position, but over the next two months, most of them are in the correct prenatal position.

If there is very little time left before the birth, and your doctor cannot determine the presenting part of the fetus during palpation of the abdomen, then he can conduct an internal examination for you to feel which part of the baby's torso is in the pelvis. Very often to confirm the position of the child to a woman.

What is external obstetric fetal rotation?

Children who by the beginning of the ninth month of pregnancy have not taken the head presentation are unlikely to do it on their own. So if your baby is still upside down at 37 weeks, your gynecologist should suggest trying to turn your baby into a more favorable head-down position.

This procedure is known as external obstetric turn on the head. The rotation of the fetus is carried out by applying pressure on the abdomen, and manually manipulating the child in the direction of his head down.

The cephalic rotation is effective in 58% of breech presentations and 90% of lateral presentations. But sometimes the baby refuses to budge, or turns back into the pelvic position even after it has already rolled over head first. Doctors have noticed that most often the rotation of the fetus works, provided that this is not the first pregnancy for a woman.

Contraindications and complications of obstetric rotation

Please note that not all women may be subject to this procedure! If you are carrying twins or your pregnancy is complicated by bleeding or oligohydramnios, this manipulation is contraindicated for you! And, of course, this procedure is not carried out for those women who in any case will give birth by caesarean section - for example, with placental presentation, carrying triplets, or having a history of two or more caesarean sections or operations on the uterus.

Severe complications, although relatively rare, can occur. For example, obstetric turn the fetus can lead to from the uterine wall, because of which the doctor will be forced to decide on an emergency caesarean section.

The procedure can also cause the baby's heart to slow down, a condition that requires immediate delivery if it doesn't go away on its own within a short amount of time.

For these reasons, the physician must perform this procedure only in a hospital with an operating room, resuscitation and medical staff, which may be needed for a caesarean section in case of any complications.

How is the rotation of the fetus on the head?

Starting at midnight before your procedure, you will not be able to eat or drink anything. This is necessary in case you end up needing surgery (caesarean section).

Advance woman passes ultrasound procedure to check the intrauterine position of the child, the number amniotic fluid and location of the placenta. Also, ultrasound will be repeated after the manipulation (some doctors use ultrasound during the procedure).

Before obstetrical rotation a woman must be prescribed a blood test for group and Rhesus compatibility with a child. If both parents are Rh-negative, then the woman is given an injection of immunoglobulin. Throughout the procedure, and some time after, the child's heart rate will be closely monitored.

Birthing tactics if fetal rotation is ineffective

In this case, the tactics of childbirth depends on many things. A woman can give birth vaginally if she is pregnant with twins, provided that the first child is cephalic and the labor progresses so rapidly that the woman is admitted to the hospital when the baby is already in the birth canal, making a caesarean section impossible.

However, the vast majority of babies with a breech or transverse presentation are delivered by caesarean section. If a caesarean section is planned, then it will most likely be carried out no earlier than the 39th week of pregnancy.

To make sure that obstetric turn did not bring results, and the child has not changed his position until that time, the expectant mother will have an ultrasound in the hospital, immediately before the operation. There is also a chance that the woman may go into labor or break her water before the date of the planned caesarean section. If this happens, you need to urgently call a doctor and go to the hospital!

It is known that in some pregnant women the fetus is in a breech presentation. There are many opinions about what kind of help such women need. And at the same time, there is a single position supported by all the leading obstetricians in the world and voiced by the World Health Organization. We came to a consensus because it was formulated on the basis of high-quality scientific research, and not on the opinion of individual experts. In this article, I will try to talk about the help that should be offered to a pregnant woman according to international recommendations.

Why obstetricians do not like breech presentation of the fetus?

Births in breech presentation have a greater risk to the health of the fetus.

What is known about the effectiveness of treatment for breech presentation?

First, you should not worry about how the fetus is located in the uterus until 36-37 weeks. It is likely that he can completely independently take the head presentation before this time. Gymnastics, which is often offered to pregnant women, turned out to be ineffective (the frequency of fetal rotations in those who perform and do not perform special exercises is the same). As a method of delivery, a caesarean section is usually offered, but independent childbirth is also possible (this can only be said after an ultrasound on the eve of childbirth and an analysis of the clinical situation by an experienced obstetrician).
Many clinics in the world have completely abandoned independent childbirth in breech presentation, delivering such pregnant women by caesarean section. However, the argument often offered in the Russian Federation that breech birth in boys leads to male infertility has no scientific evidence. This story about male infertility is a topic exaggerated in Russian obstetric literature, and it was not heard about outside the USSR.

To avoid caesarean section in all industrialized countries, pregnant women are encouraged to perform an external rotation of the fetus on the head. The obstetrician, by light pressure on the abdomen, rotates the fetus, and it becomes head presentation. This is the safest and most frequently performed procedure in obstetrics, which is practiced throughout the world. The method of turning is different from previously performed, and most importantly, it is carried out under the control of ultrasound and CTG, which means that the obstetrician has a good idea of ​​​​what is happening inside.
There are many speculations about this manipulation that I hear from both patients and medical workers. For many years of practice (I have been performing turns since 2001), I have not observed any complications of this manipulation. Although there is a risk of some complications, and it is negotiated with the pregnant woman before manipulation, the risk of such complications is extremely small. This risk is not comparable to that of a caesarean section or a breech birth.

The most common fear expressed by a pregnant woman is that the fetus can be injured or damaged. It is impossible to injure the fetus during the rotation, it is in a state of hydroweightlessness and is protected by amniotic fluid, and the rotation is carried out with light movements. In the world, such a complication has not been reported, although the manipulation is performed in large numbers.

Time manipulation lasts from a few seconds to several minutes. Although the whole process will take about 2-3 hours, because. ultrasound is preliminarily performed, CTG is recorded before and after the turn is performed. After the turn, the pregnant woman goes home. We usually ask to visit maternity hospital after 1-2 days. If the rotation is successful, then the woman will have a normal birth.

In about 30-40% of cases, the turn fails. The longer the gestation period, the more failures. Most often, the failure lies in the fact that in the process of examining a pregnant woman before turning, there are contraindications to its implementation. Less often, the rotation is carried out, but it is not possible to rotate the fetus. For those who want more scientific information, the World Health Organization Reproductive Health Library can be consulted. Fortunately, in 2008 her resume was translated into Russian.

obstetric turn I (versio obstetrica)

an operation with the help of which they change the unfavorable for the course of labor to a longitudinal one. In clinical practice, the following types of A. p. are used: external rotation on the head, external-internal classical rotation on the leg, rotation according to Braxton Hicks.

Outer turn fruit per head produced only by external methods (through the abdominal wall) with transverse and oblique positions of the fetus, less often with breech presentations. The operation is performed after the 35th week of pregnancy with good fetal mobility (until amniotic fluid is poured out), normal pelvic dimensions or its slight narrowing (true at least 8 cm), the absence of indications for the rapid completion of labor (, premature detachment of the placenta, etc.).

With oblique positions of the fetus, for external rotation, it is sometimes enough to lay the woman in labor on the side towards which the presenting part is deviated. For example, with the left oblique position of the fetus (head to the left), the woman is laid on her left side. In this position, the bottom of the uterus, together with the buttocks of the fetus, deviates to the left, and the head in the opposite direction, to the entrance to the small one.

With a transverse and persistent oblique position of the fetus, special external manual techniques are used for external rotation. Pregnant or childbirth over 30 min before surgery, administered subcutaneously 1 ml 1% solution of promedol. Must be emptied before operation. The woman is laid on a hard couch on her back, her legs are slightly bent and drawn to her stomach. The doctor sitting on the side on the edge of the couch puts both hands on the woman in labor so that one lies on the head, grabbing it from above, and the other on the underlying buttock of the fetus ( rice. one ). Having clasped in this way, with one hand they shift the head of the fetus towards the entrance to the small pelvis, and with the other they push the pelvic end up, to the bottom of the uterus. These manipulations should be done persistently, but extremely carefully.

With breech presentation of the fetus in case of ineffectiveness of the complex of special exercise aimed at correcting the position of the fetus, the doctor may try in a hospital to perform an operation of external rotation of the fetus on the head - the so-called prophylactic rotation. It is usually carried out at the 35-36th week of pregnancy. The general rules for external preventive rotation are as follows: shift towards the back, back - towards the head, head - towards the entrance to the small pelvis. After turning, it is necessary to systematically monitor the pregnant woman.

When carrying out external rotation (using manual techniques), complications are possible: fetus, premature detachment of the placenta. When the first signs of complications appear, the operation of the external rotation is stopped, according to indications, an operation is performed.

External-internal classical rotation of the fetus on the leg produced by a doctor, in emergency cases -. When it is carried out, one hand is inserted into the uterus, the other is placed on the stomach of the woman in labor. The indications are the transverse position of the fetus, incl. the transverse position of the second fetus from twins, and extensor head presentation of the fetus (for example, frontal), which is dangerous for the mother. In the presence of one fetus, the operation is carried out, as a rule, with a dead fetus. With a live fetus in similar situations, a caesarean section is preferable. Conditions for the external-internal classical rotation: full opening of the uterine os, full fetal mobility, with a live fetus, the size of the pelvis of the woman in labor must correspond to the size of the fetal head. A contraindication to turning is the so-called neglected transverse position of the fetus, in which it is immobile. Before the operation, the woman in labor should empty the bladder, disinfect the external genitalia. The operation is performed on the operating table or on the Rakhmanov bed in the position of a woman on her back. Apply deep ether or intravenous. There are three stages of the operation: the introduction of a hand into the uterus, the search for and capture of the pedicle of the fetus, the actual rotation of the fetus.

With the transverse position of the fetus in the uterus, it is recommended to insert a hand corresponding to the position of the pelvic end of the fetus. In the anterior view of the transverse position (back to the front), the underlying fetal leg should be captured (when the overlying leg is captured, the anterior transverse position can easily go into the rear view, which is unfavorable for labor management). In the rear view of the transverse position (back back), the overlying leg should be captured ( rice. 2, a ), because rear view is easier to convert to front view. Two methods of finding the fetal pedicle are recommended. When using the so-called short way the hand is held directly to the peduncle of the fetus; The “long” method consists in moving the hand along the back of the fetus to the buttocks, then along the thigh, lower leg. With the “outer” hand (lying on the abdominal wall), the pelvic end of the fetus is brought down to the entrance to the small pelvis towards the “inner” hand, thus helping to find the leg. As soon as the fetal pedicle is found and grasped (with two fingers or with the whole hand), the "outside" hand is immediately transferred from the pelvic end to the fetal head and the head is pushed to the fundus of the uterus ( rice. 2b ). Traction () for the leg is performed outside, down, towards the perineum until the fetal knee appears from the genital gap. When the leg is brought out to the knee and the fetus has taken a longitudinal position, the turn is completed. Following this, an operation is usually performed to extract the fetus by the pelvic end (see. Pelvic presentation of the fetus).

In the case of head presentation of the fetus, the arm that corresponds to the position of the small parts of the fetus is inserted into the uterus as deeply as possible (up to the elbow). Previously, the fetal head is pushed to the side. After the leg is captured, it is important to transfer the “outer” hand from the pelvic end to the head end. In order not to confuse the fetal leg with a handle, it is necessary to insert the hand deeper into the uterus, and when grasping, turn to the heel tubercle.

With the external-internal classical turn of the fetus on the leg, handles, fetal heads can occur. If the umbilical cord prolapses, it should not be set, because. the reduced part of the umbilical cord usually falls out again; the turn should be continued, trying not to press the umbilical cord. When the handle falls out, a loop is placed on it so that in the future it cannot tip over the head. If the head is infringed, it is necessary first of all to try to gently push it away; if unsuccessful, the second leg should be brought down to create more space in the uterine cavity, and again make an attempt to push the head; with the ineffectiveness of these manipulations and the dead fetus, the heads are shown (see Fruit-destroying operations). A dangerous complication of the operation is the uterus (see Childbirth).

Rotation of the fetus according to Braxton Hicks, or turning the fetus on a leg with incomplete opening of the cervix (4-6 cm), can be carried out with a transverse or oblique position of the fetus, as well as with head presentation in the case of partial placenta previa. Due to the danger to the mother and fetus, it is used extremely rarely, only with a dead or premature non-viable fetus. A necessary condition is the mobility of the fetus. The operation is performed under general anesthesia with the woman in the supine position. Two fingers are inserted into the uterus through, open, grab the fetal leg and, with the help of a hand located on the abdominal wall, turn the fetus onto the leg. Then the leg is removed from the vagina to the popliteal fossa and a weight of 400-500 is suspended from it. G(with placenta previa - no more than 250 G). The expulsion of the fetus occurs spontaneously after sufficient dilatation of the cervix.

Bibliography: Bodyazhina V.I., Zhmakin K.N. and Kiryushchenkov A.P. , from. 443, M., 1986; Grishchenko I.I. and Shuleshova A.E. Prenatal corrections of incorrect positions of the fetus, Kyiv, 1974; Multi-volume guide to obstetrics and gynecology, ed. L.S. Persianinova, vol. 6, book. 1, p. 73, M., 1961.

II Obstetric turn (versio obstetrica)

Obstetric twist classic(v. obstetrica classica; . A. p. combined external-internal) - A. p., in which the fetus is turned on the leg with the full opening of the cervix with two hands - one inserted into the uterus and the other acting through the anterior abdominal wall.

Obstetrical rotation combined external-internal- see Obstetric turn classic.

Obstetric turn external(v. obstetrica externa) - A. p., produced with the help of hands only through the abdominal wall.

1. Small medical encyclopedia. - M.: Medical Encyclopedia. 1991-96 2. First health care. - M.: Great Russian Encyclopedia. 1994 3. Encyclopedic dictionary of medical terms. - M.: Soviet Encyclopedia. - 1982-1984.

Closer to the eighth month of pregnancy, most babies turn head down, thus preparing for childbirth. But if your baby has not done this, then in 90% of cases this means that he is preparing to come out of the womb forward with his buttocks or legs. This is called breech presentation. If this is found before 35 weeks, then you can try to help the baby take the right position on your own. Sometimes from 37 weeks, you may be offered obstetric revolution. Births in which the baby is in a breech presentation (that is, booty or feet down) require more skill from obstetricians and are more likely to have complications. But that doesn't mean you can't give birth on your own.

The first thing you can do is help your baby roll over. And help you do it

1. Conversations. Do not laugh. But your attitude, your mood and words, greatly affect your baby.


2. Swimming. If there are no contraindications from your doctor, start visiting the pool! Most often, a sedentary lifestyle is the reason that the baby seems to be stuck and cannot roll over. In addition, water is a good relaxant. Aqua gymnastics and water aerobics will cheer you up, relieve tension from the spine and abdominal muscles. And your baby will be helped to roll over


3. coup. It is very important for mom lying down to roll over from side to side. Sleeping and lying in the same position can cause breech presentation. Just your baby, get comfortable too. So the first exercise is:

Lie on a hard, flat surface (sofa, couch, floor) on your side. Lie down like this for 10 minutes, roll over over your back to the other side, and lie down like this for another 10 minutes. It is good if the exercise can be done at least 2-3 times. It is best to do it before meals.

1. Kitty. One of the most recommended exercises. Get on all fours and slowly rock your hips. Bend as you inhale, and as you exhale, arch your back like a cat, and lower your head down.


2. Incline. Lie down near the wall, put a pillow under the spike, so that the pelvis is a little higher than the head, and with half-bent legs rest against the wall .. Try to relax and lie down like this for 5-10 minutes


3. Sit on the floor and connect your feet. Try to press your knees to the floor. Hold this position for 10-20 minutes. Repeat the exercise 3 times a day


4. Long live fitball! Don't be lazy, buy yourself a pregnancy ball. He will be useful to you again and again. The best exercise on it is
   
   
   • Bend your knees, put on the ball, lie on your back, raise and lower your pelvis. Repeat the exercise 10 times.
   
   
   • Bend your knees and place on the ball. Slowly rock them from side to side. Exercise repeat 10 times
   
   
   • Sit on the ball, put your feet shoulder-width apart. Start making light circular motions with your hips.
   
   

Do not be discouraged if you have done everything to make your baby roll over, and he stubbornly sits on his ass. But sometimes the child takes this position because it is most convenient for him to be in it - the length of the umbilical cord and the location of the placenta make this position convenient for the child. In this case, trying to turn the baby over is useless.

Separately, I would like to tell you about the obstetric revolution. In our country, the external rotation of the fetus is very rarely recommended, and no one dares to do the internal one at all, since the method itself is considered outdated and unreliable. There is a risk that the child from the head, after turning, will go into a transverse presentation - and from there it will be almost 100% delivered by caesarean.
Decide unambiguously future mother and her doctor.

Obstetric rotation is an operation with the help of which it is possible to change the position of the fetus, which is unfavorable for the course of childbirth, to a favorable one, and, always, only longitudinal. There are the following methods of obstetric rotation: outer turn on the head, less often on the pelvic end; inner turn with the full opening of the uterine pharynx - a classic, or timely, turn.
The external rotation of the fetus is performed by the doctor only by external methods through the abdominal wall without any influence from the vagina. Indications: transverse and oblique positions of the fetus, pelvic presentation of the fetus. Conditions for carrying out: good fetal mobility (with receded waters, rotation is not shown); normal pelvic dimensions (true conjugate not less than 8 cm); lack of indications for the rapid end of labor (fetal asphyxia, premature detachment of the placenta, etc.).

There are also contraindications.

Please note that not all women may be subject to this procedure! If you are carrying twins or your pregnancy is complicated by bleeding or oligohydramnios, this manipulation is contraindicated for you! And, of course, this procedure is not carried out for those women who, in any case, will give birth by caesarean section - for example, with placental presentation, carrying triplets, or having a history of two or more caesarean sections or operations on the uterus. Severe complications, although relatively rare, can occur. For example, obstetric fetal rotation can cause the placenta to detach from the wall of the uterus, forcing the doctor to decide on an emergency caesarean section. The procedure can also cause the baby's heart to slow down, a condition that requires immediate delivery if it doesn't go away on its own within a short amount of time. For these reasons, the doctor should only perform this procedure in a hospital with an operating theater, intensive care unit, and medical staff that may be needed to perform a caesarean section in the event of any complications.

Technique of obstetric coup.

The classic internal rotation is performed only by a doctor. When carrying out an internal obstetric turn, one hand is inserted into the uterus, the other through the abdominal wall of the woman in labor helps the first. A classic internal rotation is shown in the transverse position of the fetus, as well as in presentations dangerous for the mother (for example, frontal) and insertions of the head (for example, posterior parietal). With a classic turn, you can turn the fetus from a transverse position (sometimes longitudinal) to the head and to the leg. Turning to the head is currently of no practical importance. Conditions for rotation: full opening of the uterine os, full fetal mobility. A contraindication to internal rotation is the neglected transverse position of the fetus.
Today, doctors rarely risk the health of a woman in labor and a child. Therefore, caesarean is preferred to an internal coup.

Easy pregnancy and childbirth!