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Prezentatia pelviana a copilului

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De cele mai multe ori, in timpul sarcinii lucrurile isi urmeaza cursul normal si fatul se pozitioneaza cu capul in jos (pentru a trece prin pelvis), pentru a-si face intrarea in aceasta lume. Ocazional, se intampla ca fatul sa ramana in pozitia cu capul in sus, in apropierea coastelor tale si cu posteriorul in jos, la baza pelvisului. Aceasta se numeste prezentatia pelviana.

Sunt multi factori care stau la baza prezentatiei pelviene a fatului. De multe ori se intampla pur si simplu, fara vreo cauza medicala propriu-zisa. Se poate intampla in cazul gemenilor sau sarcinilor cu multiplii feti cand nu este suficient spatiu care sa permita copiilor sa-si schimbe pozitia.  Situatia poate fi cauzata si de cantitatea insuficienta de fluid amniotic, de un cordon ombilical prea scurt sau alte anomalii uterine. Daca copilul tau sufera de malformatii congenitale, este probabil sa fie intr-o prezentatie pelviana.

Prezentatia pelviana apare la mai putin de 5% din sarcini. Copiii care se nasc prematur au toate sansele sa se pozitioneze cu capul in sus, neavand suficient timp sa se roteasca. In a 28-a saptamana a sarcinii, 25% din feti sunt inca in pozitia cu capul in sus. Rotirea copilului are la baza forta gravitationala care actioneaza asupra capului acestuia, astfel ca o data cu avansarea sarcinii si implinirea termenului (cu cat fatul este mai mare) se reduce drastic procentul prezentatiilor anormale.

 

Tipuri de prezentatii pelviene

prezentatia franca / sezutul primul, cand bebelusul iese cu fundul inainte, iar picioare ii sunt dupa urechi.

prezentatia completa / picioarele primele, cand bebelusul are picioarele incrucisate si iese cu fundul inainte.

prezentatia incompleta podalica, atunci cand fundul este pozitionat mai sus in uter, iar unul sau ambele picioruse ajung sa atarne in cervixul uterin (fiind primele care ies)

prezentatia incompleta cu coapsele in extensie si gambele flexate (in genunchi, in partea superioara a osului pelvian)

Cea mai des intalnita forma este prezentatia franca, ultimele doua fiind cel mai rar intalnite.

 

Schimbarea pozitiei copilului

Unele cupluri prefera manevrele prin care medicul poate rasuci copilul (versiunea externa). Aceste metode se aplica de regula la spital de catre medicul obstetrician, iar in timpul lor fatul este monitorizat, pentru a exclude stresul pe care-l poate resimti.

In cazul in care copilul nu se poate intoarce cu capul in jos, nasterea va avea loc prin cezariana.

Exista riscuri in a duce la termen o sarcina cu prezentatie pelviana, cum ar fi: deprivarea de oxigen, colapsul cordonului ombilical, cand capul copilului se blocheaza in canal, deoarece fundul moale nu poate sa dilate suficient cervixul, sau copilul poate suferi leziuni la nivelul craniului si al creierului. Din aceste cauze, medicul va opta pentru nasterea prin cezariana atunci cand copilul are o prezentatie pelviana - nastere mult mai sigura atat pentru mama, cat si pentru copil.







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