Bank position
| Classification according to ICD-10 | |
|---|---|
| O32.2 | Care of the mother in lateral and inclined positions |
| ICD-10 online (WHO version 2019) | |
Transverse position ( English transversal lie ) is a rarely occurring obstetric positional anomaly of the child in the womb. The main body axis of the child forms a right angle with that of the mother or with the so-called “guide line” of the birth canal , which excludes natural birth and it is an “impossible position” that requires a caesarean section (Sectio caesarea).
From an inclined position ( English oblique lie ) is used when the body main axes of the child and the mother form an acute angle. By itself, this position setting is "unstable" and is changed to a longitudinal or transverse position under the influence of the labor activity. The diagnosis of an inclined position is therefore initially only to be seen as a warning, especially since in a study in 83 percent of the cases a spontaneous application in a longitudinal position (52 percent skull position , 31 percent breech position ) occurred.
In the ICD-10 , the "care of the mother in lateral and inclined position" is coded with O32.2. This includes conditions as a reason for "observation, inpatient treatment or other obstetric care of the mother or for caesarean section before labor begins".
frequency
The diagnosis of a bank angle is made in 0.3-0.6 percent of births. However, the incidence rises with the number of previous births ( parity ), so that women who have given birth more than four times are ten times more likely to be transverse. A lateral position can be diagnosed by the external findings ( Leopold handles ) or by ultrasound .
The rate of transverse positions in premature births is also significantly higher , so that the incidence is given here as three percent. Other factors that favor a bank position are, besides multiparity and premature birth
- Multiple pregnancy (young children)
- Placenta previa
- Polyhydramnios
- fetal malformations
- Uterine malformations
- Tumors in the pelvis
- (rarely a) narrow pelvis
Complications, therapy
Typical complications for the transverse position are premature rupture of the bladder , umbilical cord prolapse and uterine rupture due to overstretching.
An outward turn of the child can occur in the 34th – 37th Week of pregnancy should be aimed for. This works best with an existing polyhydramnios and with multiple giving births . This is contraindicated if the child is dragged sideways and the child is wedged (shoulder wedged, arm prolapse). An inner turn is only carried out in the case of twin births if, after the birth of the 1st twin, the 2nd twin lies in a transverse position.
Since the risk for mother and child is greatest after the start of labor or bladder rupture , the indication for a caesarean section is made early.
Web links
Individual evidence
- ↑ a b c P. Böhi: Positional anomalies including breech position . ( Memento of the original from September 28, 2007 in the Internet Archive ) Info: The archive link was inserted automatically and has not yet been checked. Please check the original and archive link according to the instructions and then remove this notice. (PDF; 1.6 MB) [... and including horizontal position] 2006
- ↑ Handbook Geburtenregister Österreich (June 2005) ( Memento of the original from July 23, 2007 in the Internet Archive ; PDF) Info: The archive link was inserted automatically and has not yet been checked. Please check the original and archive link according to the instructions and then remove this notice.
- ↑ Quality assurance project office at the Westfalen-Lippe Medical Association: Prinatal Survey 1999 ( Memento of the original from September 28, 2007 in the Internet Archive ; PDF; 39 kB) Info: The archive link was inserted automatically and has not yet been checked. Please check the original and archive link according to the instructions and then remove this notice.
