Attitude anomaly

The Attitude anomaly is a birth complication in which the unborn child does not descend into the mother's pelvis in a way that is not conducive to the birth and assumes an obstructive position. In most cases the birth stagnates completely with the attitude abnormality. In order to deliver the child, measures such as caesarean section or surgical vaginal birth are available.

What is a hiring anomaly?

Various complications during the birth process still occur today in a prevalence that should not be underestimated, despite medical progress. Some external factors increase the risk of such complications, such as the old age of the mother-to-be. Another risk factor for disorders of the physiologically normal course of labor are so-called attitude anomalies.

These are incorrect positions that the embryo assumes when descending into the mother's pelvis. Different types of attitude anomaly exist. In addition to the high straight position, the parietal bones position, the low transverse position of the head, the posterior occipital position and shoulder dystocia are among the most common anomalies. Position anomalies such as the horizontal or inclined position are to be distinguished from the setting anomaly.

The attitude anomaly, unlike the positional anomaly, relates to the repositioning of the childbearing fetus immediately before birth. This repositioning usually leads to a position that favors the birth process. The high transverse position of the head and the transverse shoulder position are the most fertile positions.

causes

Typically, the cause of an attitude abnormality is an abnormality of the maternal pelvis. If the pelvic bones are misaligned, the unborn child is often unable to descend into a position conducive to birth despite efforts. However, an attitude abnormality does not necessarily have to have a physical cause.

In some cases, emotional factors can be the primary cause of an apparent attitude abnormality and the associated stagnation in childbirth. The distinction between real attitude anomalies with physical causes and apparent but spurious attitude anomalies with purely psychological causes is an important criterion for the correct procedure during childbirth.

In principle, midwives and gynecologists only speak of a real adjustment anomaly if the unborn child does not turn in the mother's pelvis into a position that enables spontaneous birth.

Symptoms, ailments & signs

The main symptom of an attitude anomaly is stagnation of the birth process. As long as the child does not move into a position conducive to childbirth, the birth process cannot proceed. The doctor and midwives determine which adjustment anomaly is present in each individual case during the birth process.

The posterior occipital position is one of the most common adjustment anomalies. The face of the unborn child does not point towards the back of the mother-to-be, but rather towards the stomach, similar to a stargazer. The child's head must slide through the mother's pelvis with its largest diameter first. Attitude abnormalities do not always result in a birth arrest.

Unborn children in the parietal position relatively often leave the maternal pelvis in a spontaneous part. Furthermore, a birth arrest in the other direction does not necessarily have to indicate an attitude anomaly.

diagnosis

Often, before a child is born, an abnormality of the maternal pelvis is detected. To diagnose such an abnormality, pelvic imaging is the method of choice. If a pelvic abnormality is known prior to delivery, there is a higher risk of an attitude abnormality during labor.

In this case, the midwives and doctors will pay particular attention to the position of the child and carefully check whether the unborn child is in a position conducive to birth. In most cases, an anomaly that has already occurred can be diagnosed within seconds using palpation and ultrasound. The further course of action is planned depending on the type of setting anomaly.

Complications

An ordinary birth of the child is not possible due to the anomaly. An alternative method must be used to remove the child from the mother's womb, usually using a caesarean section. The attitude abnormality can be diagnosed relatively well, so that there are no particular complications at birth itself.

Diagnosis is made with the help of ultrasound and is not associated with pain. Depending on the location and position of the child, it is then decided how the further course of the birth will look like. In some cases a spontaneous delivery occurs, which, however, cannot be foreseen. Any pain that the mother may experience is treated with pain relievers.

If the child's position does not change, an operative delivery by caesarean section is performed. In most cases the delivery goes without difficulties or complications. The physical functions of the child are not impaired by the abnormal attitude, nor is there any reduction in life expectancy. In most cases, the mother is left with a scar on her stomach after giving birth.

When should you go to the doctor?

According to today's conventional medical opinion, women giving birth should generally work closely with a team of doctors, nurses and a midwife. It is advisable to attend all the prenatal check-ups that are offered and to always have irregularities and abnormalities clarified by a doctor.

Precautions should be prepared and planned well in advance several weeks before the birth. If the expectant mother has a vague feeling that something is wrong despite all the examinations and agreements, she should speak about it.

If there are irregularities or if there are spontaneous changes in the physical condition, a doctor must be informed. If the contractions start unplanned and too early, a doctor and midwife should be contacted immediately. Depending on the intensity of the pain or the interval between the contractions, it is important to consider whether an ambulance should be called. If the symptoms increase abnormally, an emergency doctor must be informed.

If the birth has already started but then stagnates, there is cause for concern. Since the life of both mother and child can be endangered during childbirth, a doctor must be clarified which steps must be taken if the child does not turn independently into the correct birth position. The mother-to-be should refrain from giving birth at home if the pregnancy is classified as high-risk and should go to the care of doctors in good time.

Doctors & therapists in your area

Treatment & Therapy

In the case of some adjustment anomalies, the patient has to wait some time, as a spontaneous delivery is still possible despite the anomaly. This is especially true for the front parietal adjustment. In the case of other anomalies, the mother is first asked to change her own situation. If the child is standing low on the head, a change in position of the mother can lead to spontaneous delivery, for example.

If necessary and so desired, the expectant mother receives conservative drug treatment with painkillers. In addition, means of relaxation can help a spontaneous delivery in some cases. If neither a change in position nor relaxation allow a spontaneous delivery, the child must be surgically delivered.

The use of a suction cup is preferred to the caesarean section, as far as this approach makes sense. The same applies to the forceps with which the obstetrician or the doctor can bring the unborn child into a beneficial position if necessary. A vaginal-operative delivery is also conceivable after an adjustment anomaly.

The delivery by caesarean section is carried out in an absolute emergency and usually only takes place when all other means have failed. When treating abnormal attitudes, it is important to monitor the child's vital functions. Obstetricians and gynecologists will only be able to determine the right time for an invasive birthing procedure with precise monitoring.

Outlook & forecast

Attitude abnormality is a condition during childbirth and is not a disease based on a genetic defect or pathogen. The abnormality can only occur during labor and causes the birth to stop. In these cases the use of an alternative birthing process becomes necessary. The attitude anomaly is therefore a condition which only affects an expectant mother and which requires action to ensure the survival of mother and child.

If the misalignment of the fetus in the womb is discovered early, a pelvic narrowing of the pregnant woman or the first complications during the birth process, delivery is initiated by caesarean section. This is a routine surgical procedure that in most cases proceeds without any further complications. The diagnosis is made before the expected due date by means of an ultrasound examination.

With good wound care and adequate sparing of the woman, recovery occurs within a short time after the caesarean section. Without medical care and intervention, there are serious complications for both mother and child. The result is an insufficient supply of oxygen to the fetus, as natural birth is not possible due to the circumstances of the mother and child. This threatens the unborn child with death by suffocation. The mother-to-be is also in mortal danger.

prevention

Pelvic anomalies are the leading cause of attitude anomalies. A pelvic anomaly can be congenital and cannot be prevented. However, acquired cheek anomalies also exist, such as those that can arise from improper posture. In order to prevent pelvic anomalies acquired in this way, it makes sense to attend a husbandry school.

Preventing pelvic misalignments also reduces the risk of abnormal attitudes during the birth of a child. An adjustment anomaly cannot be ruled out even if there is no pelvic anomaly in the expectant mother.

Aftercare

In the case of an adjustment abnormality, follow-up measures are usually not possible or necessary. This complication must always be treated immediately by a doctor, otherwise, in the worst case, it can lead to the death of the child and also the death of the mother. The earlier the attitude anomaly is detected, the better the further course of this complaint will generally be.

A cure is not always possible. The aftercare itself is mostly directed towards the treatment of the wound after the caesarean section in the mother. The mother should definitely rest and take care of herself after this procedure. In any case, bed rest should be observed, and stressful and physical activities should be avoided as far as possible. In many cases, this also requires the support of your own family and parents.

Loving and intensive care of the mother and child always has a positive effect on the further course of the attitude anomaly. As a rule, no further follow-up measures are necessary for this disease. However, after the wound has healed, regular examinations can be useful. Life expectancy will not be reduced if the attitude abnormality is treated successfully.

You can do that yourself

A mother giving birth should inform herself in good time and comprehensively about possible complications and various possibilities of giving birth in advance of the birth. The choice of the right method depends on the individual circumstances and must always be made in consultation with the obstetrician. The better the expectant mother is informed about the course of the birth, the more prepared she can react to unplanned developments that may arise during an ongoing birth.

Breathing techniques should be practiced sufficiently and the conditions for an undisturbed birth process should be created. It is helpful to exchange ideas with experienced people and to ask all questions that arise early on and to have them answered. As the birthing process develops, it is important to work closely with the obstetrician team and to follow their instructions. The expectant mother shouldn't panic and give feedback about any change in her body.

Despite the pain and possible irregularities, the mother helps herself and the unborn child if she remains calm. The psyche of those affected should be stable months before the birth so that as few complications as possible occur. If in doubt, it is helpful to get support and help in good time. This alleviates the stresses and strains of childbirth for both mother and child.