Malposition of Vertex (Baby's Head Turned in Wrong Position for Delivery)

What is malposition of vertex?

Malposition of vertex is one of the positions a baby can be in before delivery. A baby is in a vertex position when the baby's head is going to come out first, before the rest of the body. During normal labor the baby's head turns so that the baby's face is toward the mother's back. If the baby’s head does not turn, it is called malposition. This position may make labor more difficult.

What is the cause?

Malposition may happen because:

  • Contractions of the uterus are not strong enough to help the baby turn his or her head to the proper position.
  • The mother’s pelvic bones are shaped in a way that makes it hard for the baby’s head to be in the right position.

What are the symptoms?

The symptoms of malposition of vertex may include:

  • A lot of back pain
  • Longer, more tiring labor

How is it treated?

There are a number of possible treatments for this problem.

  • You may be asked to lie on your side or with your knees against your chest.
  • When your healthcare provider can see the baby's head in the opening of the vagina, your provider may try to turn the baby's head with his or her hands.
  • A drug called oxytocin may be given to you with an IV. This medicine can make your contractions stronger and help the baby's head come down the birth canal and turn.
  • Your healthcare provider may use forceps to turn the baby's head. Forceps are large metal instruments like spoons that fit alongside the baby's head. Your provider may use forceps to deliver the baby by gently pulling the baby's head down.
  • Your provider may use vacuum rotation to deliver the baby. This is done by placing a plastic or metal cup called a vacuum extractor on the baby's head and applying suction. Your healthcare provider will pull gently on the baby's head during a contraction while you are pushing.

Your healthcare provider may decide to deliver the baby with surgery (C-section) if:

  • Your provider decides a forceps or vacuum delivery would be too dangerous for the baby.
  • A forceps or vacuum delivery is tried and doesn’t work.
  • Your provider decides the baby is too big to pass through the pelvis.

How can I take care of myself?

  • Remain calm and follow the directions of your healthcare provider.
  • It may help to use the breathing and relaxation techniques you learned and practiced in prenatal classes.
  • If you are concerned about this or any other problem that might happen during delivery, talk about your concerns and questions with your healthcare provider ahead of time. This will help you deal with a normal or problem delivery in the safest and calmest way possible.

What can be done to help prevent malposition of vertex?

There is no general way to prevent malposition of vertex. However, regular prenatal visits may help your healthcare provider detect problems ahead of time. Ask your provider about ways you can help lower the risk of problems during delivery.

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Published by RelayHealth.
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