User:Noellevo/Asynclitic birth

An asynclitic birth or asynclitism refers to a term used in obstetrics to describe a situation that can occur during childbirth in which the position of the head of the fetus in the uterus is titled to the side such that it is not aligned symmetrically with the birth canal. Asynclitic presentation is significantly different from a shoulder presentation, in which the shoulder is presenting first. Many babies enter the pelvis in an asynclitic presentation, and most asynclitism corrects spontaneously as part of the normal birthing process. Fetal head asynclitism may affect the progression of labor, increase the need for obstetrical intervention, and even be associated with difficult or failed instrumental delivery. However, the prevalence of asynclitism at transperineal ultrasound was rather common in nulliparous women at second stage of labor and seemed more commonly associated with nonocciput anterior position, suggesting a developmental correction occurs in many cases. When the self-correction does not occur, obstetrical intervention is necessary to delivery the child. Persistence of asynclitism can cause problems with dystocia, and has often been associated with cesarean birth. However, with a skilled midwife or obstetrician a complication-free vaginal birth can sometimes, though not necessarily, be achieved through movement and positioning of the birthing woman, and patience and extra time to allow for movement of the baby through the pelvis and moulding of the skull during the birthing process if this is safe in the circumstances. Other options include use of vacuum-assisted delivery and forceps. There is no evidence to suggest that people with previous asynclitic presentation are more likely to experience it in subsequent childbirth.

Diagnosis of Asynclitic Birth
Asynclitism can be digitally diagnosed using intrapartum ultrasound through the transabdominal cavity and the transperitoneal cavity. Intrapartum ultrasonography is regularly used during pregnancy to constantly monitor the fetal position within the mother's belly. add the reason why the position changes, water changes and other factors that affect occiput positions. Asynclitism is most easily diagnosed during labor when the cervix is opened allowing the orientation of the occiput, the back of the fetal head, to be visually assessed in relation to the mother's pelvis. Posterior asynclitism is when the fetal occiput is facing the mother's spine whereas, anterior asynclitism is when the fetal occiput is facing the mother's belly. The most common and preferred type of asynclitism is the left occiput anterior asynclitism because the baby's head is the first part. add in the reason why this position is favorable and how it affects delivery.

Complications
Asynclitism is common as the fetus enters through and tilts the maternal pelvis, and there are various types that can occur: anterior, posterior, and lateral asynclitism. Minor asynclitism generally resolves itself and results in uncomplicated births. Minor cases present as mild molding and the slight deviation of the head from the midline, but otherwise absent of major fetal head malpositioning. In cases that present with persistent occiput posterior or transverse positions, this can result in prolonged and difficult delivery, and may warrant obstetrical intervention.

There are complications that occur before, during, and after birth that affect both the baby and the mother. If the fetus' head is not optimally positioned, this can result in dystocia and subsequently having to undergo operative delivery. There are complications associated with procedures such as operational vaginal delivery (OVD), particularly with the use of vacuum extraction, and caesarean section (CS). Caesarean sections can increase the risk of maternal complications, which can affect future pregnancies. These include uterine ruptures, chronic pain, hemorrhages, and bladder injury. One of the more severe complications is placenta accreta, which can lead to a life-threatening hemorrhage and peripartum hysterectomy.

Some of the complications the baby may face include cephalohematomas, hyperbilirubinemia, and intracranial hermorrhages. The mother may experience complications such as vaginal or cervical tears, excessive blood loss, infection of the placental membrane, and postpartum infection.