Finding out the position of the fetus in the uterine cavity is of exceptional importance for the management of pregnancy and childbirth. In the study of pregnant women and women in labor, the articulation, position, position, type and presentation of the fetus are determined. The articulation of the fetus (habitus) is the ratio of its limbs to the head and torso. In a typical normal articulation, the body is bent, the head is tilted to the chest, the legs are bent at the hip and knee joints and pressed to the stomach, the arms are crossed on the chest. With a normal flexion type of articulation, the fetus has the shape of an ovoid, the length of which during full-term pregnancy is on average 25-26 cm. fetus lead to a short-term change in the position of the limbs, but do not violate the characteristic articulation. Violation of the typical articulation (extension of the head, etc.) occurs in 1-2% of childbirth and complicates their course. Rice. 45. The position of the fetus in the uterus. a - longitudinal position, occipital presentation, first position, anterior view; b - view from the side of the exit of the pelvis. The sagittal suture is in the right oblique size, the small fontanelle is anterior to the left. The longitudinal position is normal, it occurs in 99.5% of all births. The transverse and oblique positions are pathological and occur in 0.5% of deliveries.

In the transverse and oblique positions, insurmountable obstacles arise for the birth of the fetus. Childbirth is completed with the help of a doctor. Fetal position (positio) - the ratio of the back of the fetus to the right and left sides of the uterus. There are two positions: first and second. In the first position, the back of the fetus is facing the left side of the uterus, in the second, to the right. The first position is more common than the second, which is explained by the turn of the uterus on the left side anteriorly. The back of the fetus is not always turned to the right or to the left, it is usually slightly turned anteriorly or backwards, therefore, the type of position is distinguished. Type of position (visus) - the ratio of the back of the fetus to the anterior or posterior wall of the uterus. If the back is facing forward, they speak of the front view of the position (Fig. 46), if backward - about the rear (Fig. 47, 48).

Rice. 46. ​​The position of the fetus in the uterus. a - longitudinal position, occipital presentation. second position, front view; b - view from the side of the exit of the pelvis. Arrow-shaped suture in the left oblique size, small fontanel on the right anteriorly. Rice. 47. The position of the fetus in the uterus. a - longitudinal position, occipital presentation, first position, rear view; b - view from the side of the exit of the pelvis. Sagittal suture in the left oblique size, small fontanel on the left posteriorly. Rice. 48. The position of the fetus in the uterus. a - longitudinal position. occipital presentation, second position, posterior view; b - view from the side of the exit of the pelvis. Sagittal suture in the right oblique size, small fontanel on the right posteriorly. Rice. 49. Longitudinal position, breech presentation, first position, anterior view.

In transverse and oblique positions, the position is determined not by the back, but by the head: the head on the left is the first position (Fig. 51), on the right is the second position. The presenting part (pars praevia) is the part of the fetus that is located closer to the entrance to the small pelvis and passes through the birth canal first. In cephalic presentation, the back of the head (occipital presentation), crown (anterocephalic), forehead (frontal) and face of the fetus (facial presentation) can be turned to the entrance to the small pelvis. Occipital presentation (flexion type) is typical. With anterior, frontal and facial presentation, the head is in varying degrees of extension. The extensor type of presentation occurs in 1% of all longitudinal positions.

Rice. 50. Longitudinal position, breech presentation, second position, rear view. Rice. 51. Transverse position, first position, front view.

Asynclitic insertion is characterized by the fact that the vertical axis of the head is not strictly perpendicular to the plane of entry into the pelvis, and the sagittal suture is located closer to the promontorium or symphysis.

If the sagittal suture is closer to the promontorium, they speak of anterior asynclitism (the anterior parietal bone is inserted), if the sagittal suture is closer to the symphysis, posterior asynclitism (the posterior parietal bone is inserted). Synclitic insertion of the head is normal. During normal delivery, a temporary, mild anterior asynclitism is sometimes observed, which is spontaneously replaced by a synclic insertion. Often pronounced anterior asynclitism occurs during childbirth with a narrow (flat) pelvis as a process of adaptation to its spatial features. Pronounced anterior and posterior asynclitism is a pathological phenomenon. The stable position of the fetus in the uterine cavity is established in the last months of pregnancy. In the first and at the beginning of the second half of pregnancy, the position of the fetus changes due to the fact that the relative size of the uterine cavity and amniotic fluid at the indicated time is greater than at the end of pregnancy. In the first half of pregnancy, breech presentations are often observed, which subsequently pass into the head. Facial presentations are usually created during childbirth. The position and its appearance are also formed in the second half of pregnancy. Relatively constant is the articulation of the fetus; he makes movements, after which the articulation becomes the same. The reasons for the emergence of a typical position of the fetus in the uterus have not been clarified accurately. It was assumed that the head descends due to its severity and therefore the longitudinal position and head presentation most often occur. However, this assumption has not been confirmed, because in the first half of pregnancy, when the relative size of the head is greater in relation to the body, breech presentation and transverse position occur more often than in recent months. In creating a typical position of the fetus, its motor activity and reflex responses of the uterus play the main role. The motor activity of the fetus and the excitability of the uterus increase as the pregnancy progresses. When the fetus moves, irritation of the receptors of the uterus and its contractions occur, correcting the position of the fetus. With contractions of the uterus, its transverse size decreases, which contributes to the formation of a longitudinal position; the head, which has a smaller volume compared to the pelvic end, descends downward, where the space is smaller than in the bottom of the uterus.

Middle back line(fig.4.2)

In products with a continuous back for all figures and in products with a split back for figures with normal and kinky posture, the upper part of the back is not retracted. In products with a split back for stooped figures, most often found among older children, the middle line of the back in the upper part to the level of the shoulder blades is taken away from the vertical. from point A 0 to the right horizontally lay the amount of retraction:

A 0 A 0 " = 0.5÷1.0 cm.

The removal of the middle line of the back at the level of the waist line depends on the silhouette of the product, the presence of a seam in the middle of the back and on the features of the physique of the figure. The values ​​​​of the withdrawal of the middle line of the back at the level of the waist are given in table 4.1. The amount of withdrawal is set aside from the point T right horizontally and get a point T 1 .

a B C

Rice. 4.2. Scheme for constructing the middle line of the back: a - without a middle seam;

b - with an average seam in products of a direct silhouette; c - with an average seam in products of a semi-adjacent silhouette

In products with a continuous back, a point A 0 connect with a straight line to a dot T 1 and continue it to the bottom level ( rice. 4.2a). The point of intersection with the line of the hips is indicated B 1 .

In products with a split back (with a seam in the middle), a point A 0 (A 0 " ) are connected by a straight line with a point At. point At connect a line to a point T 1 and continue it to the bottom level. The middle line of the back in the upper part is drawn with a smooth curve ( rice. 4.2b).

To increase the fit in products with a split back, an additional tuck is made at the waist line in the middle seam of the back ( rice. 4.2v):

T 1 T 11 = 1.0÷1.5 cm.

Distance T 1 T 11 divided in half, the resulting point is connected by a straight line to the point B 1 and continue down to the bottom. points A 0 (A 0 " ), At, T 11 And B 1 connect with a smooth line .

The intersection of the final midline of the back with the line of the chest is indicated by a dot G.

The waist line is drawn perpendicular to the lower part of the midline of the back ( rice. 4.2).

Back neck(rice. 4.3)

from point A 0 (A 0 ׳ ) to the right horizontally lay a segment equal to the width of the neck of the back

A 0 A 2 (A 0 "A 2 )= Ssh/ 3 + Pshg.

from point A 2 down vertically lay a segment equal to the height (depth) of the neck of the back:

A 2 A 1 = A 0 A = A 0 A 2 (A 0 "A 2 )/ 3 + Pvgs.

The horizontal section of the neckline of the backrest is carried out perpendicular to the upper part of the formed middle line of the backrest.

from point A down the midline of the back lay the length of the product:

AN(AN 1 ) = Di + Pdts.

The bottom line is drawn through the point H(H 1 ) perpendicular to the lower part of the midline of the back.

Shoulder cut back(fig.4.3)

The position of the end of the shoulder seam of the back (point P 1 ) is determined by the intersection of two arcs: arcs from the point A 2 with a radius equal to the width of the shoulder slope ( Shp) plus the opening of the tuck (if any) and plus the amount of fit and arc from the point T(if there is a withdrawal of the middle line of the back - from the point T 1 ) with a radius equal to the dimensional attribute VPK II plus Pdts II and plus an allowance for the shoulder padding (in the upper products) equal to 0.5 ÷ 1.0 cm:

A 2 P 1 = Shn + tuck solution + landing;

T(T 1 )P 1 = Vpk II + Pdts II + (0.5÷1) cm.

For products of straight and free silhouettes of the site T(T 1 )P 1 are reduced by 0.5÷1.5 cm depending on the notch of the back at waist level or by the difference ( dts II – DTS II O) - when using a dimensional attribute dts II O.

The volume of the back, necessary to fit the shoulder blades, in the design drawing is provided with allowances for the formation of the back of the product with the help of darts, fit and suture of the fabric along the shoulder cut and armhole. Usually, a tuck solution in the shoulder section is designed, equal to 1.5 ÷ 2.0 cm, and an additional fabric fit of 0.5 ÷ 1 cm. For stooped figures, the tuck is increased by 0.5 cm.

Rice. 4.3. Scheme for constructing the upper contour lines

backs and shelves

The position of the shoulder tuck is determined by the model and body features. For typical figures, the distance from the highest point of the neck of the back to the tuck is 1/4÷1/3 of the length of the shoulder section.

The direction of the tuck depends on the model, but it is usually placed parallel to the middle of the back. The length of the tuck is 5.0÷8.0 cm, depending on the size of the solution: the shorter length corresponds to the smaller size of the tuck solution.

Dimensional sign vprz II ensures the fit of the shoulder blades, therefore, a tuck (sutyuzhka) on the back is designed along the line of the armhole: for typical figures 0.5 ÷ 1.0 cm; for figures with sharply protruding shoulder blades (stooped) - 1.5 cm.

Considering that the dimension VPK II does not pass through the center of the shoulder blades, i.e. does not fully reflect the bulge of the shoulder blades, half the size of the suture along the armhole is laid vertically upwards from the point P 1 and get a point P 11 .

The size of the suture in the armhole, depending on the model, can be left in place or moved additionally to the tuck of the shoulder section. In products with a yoke, the suture allowance can be moved to the line of attaching the yoke, in products with a cut-off bodice or undercut along the waist line - into a tuck along the waist line. In products made of fabrics of soft structures, this allowance can be sewn along the line of the armhole.

Finally, the shoulder section is drawn up by connecting the points A 2 And P 1 " in a straight line with a closed tuck.

Back armhole(fig.4.3)

To decorate the line of the armhole, the backs determine the auxiliary points P 2 ,P 3 , 1 ,G 2 .

point P 2 found by drawing a perpendicular from a point P 1 " to the vertical from a point A.

From a point G 1 put a cut up G 1 P 3 and get the touch point of the armhole with the vertical from the point A:

G 1 P 3 = P 2 G 1 / 3 + (1.5÷2.0) cm.

moreover, a smaller value is taken for younger girls, and a larger one for older girls.

Auxiliary point 1 lies on the bisector of the angle P, its position depends on the width of the armhole and is determined by the formula:

G 1 1 = 0,2G 1 G 4 + (0.3÷0.5) ​​cm.

Middle of armhole - dot G 2 :

G 1 G 2 = 0,5Shpr.

The armhole line of the back is drawn through the points P 1 ", P 3 , 1 And G 2 .

When designing the armhole line, it is taken into account that in the product, when the middle line of the back is retracted and during its final design, losses in its width occur. To maintain the width of the backrest horizontally at the level of the line of the shoulder blades, to the right of the line of the armhole, a segment is set aside equal to the distance from the vertical from the point A 0 to the midline of the back, and the armhole line is drawn through the resulting point.

Subject

Construction of the midline of the back

The abduction of the midline of the back of the TT 1 depends on the silhouette and type of the midline of the back (split, continuous). The same parameters affect the calculation of the value of the additional expansion of the drawing grid (Gg). GG calculate:

0.5 TT 1 - for an uncut middle line of the back;

0.6 TT 1 - for semi-adjacent and fitted silhouettes, the back is split;

0.3 TT 1 - for a straight silhouette, the back is split.

The values ​​of the leads of TT 1 of the middle line of the back at the level of the waist are taken as follows (Figure 1):

· for a straight silhouette:

in products with a split back (Figure 1, b) without darts on the waist line, the lead is 1.0 cm;

in products with a continuous back (Figure 1, a) without darts at the waist line -1.5 cm;

· for a semi-adjacent silhouette :

in products with a split back (Figure 1, b):

§ with darts along the waist line - 1.0 cm;

§ without darts - 1.5 cm.

§ with darts along the waist line - 1.5 cm;

§ without darts - 2.0 cm;

· for adjacent silhouette:

in products with a split back (Figure 1, c):

§ with darts on the waist line - 1.5 cm;

in products with a continuous back (Figure 1, a):

§ with darts along the waist line -2.0 cm.

It should be noted:

1. For curved figures, the abduction of the midline of the back is reduced, and for stooped figures, it is increased by 0.5 cm relative to the values ​​\u200b\u200bgiven above.

2. For figures with an increased bulge of the buttocks, the middle line of the back at waist level is not taken away.

3. In free-form products with an increased volume of the back, the middle line is also not diverted.

Construction and design of the midline of the back

Down from point A 0 vertically lay segments that determine:

blade level:

A 0 Y \u003d 0.4 Dts2;

armhole depth line:

A 0 G \u003d Vprz2 + Pspr + 0.5 Pdts.

For full figures, starting from the 104th size, the armhole depth is increased by 0.5 cm.

waist level

A 0 T \u003d Dts2 + Pdts.

For figures with a large notch in the back along the waist line, for products with a straight silhouette, the measurement Dts2o (according to the plumb line) is used.

Hip line level

TB = 0.5 Dts -2.0.

From the obtained points G, T, B, horizontal lines are drawn to the right.

Middle back line. To ensure that the figure fits correctly, the middle line of the back in the upper part to the level of the shoulder blades is taken away from the vertical from point A 0 to the right (in products with a split back) and marked with point A 0 ". For figures with normal posture, the upper lead is 0.5 cm, for kinky ones, the middle line is not retracted at the top, and for stooped ones, the retraction increases to 1.0 cm.

In the presence of fatty deposits in the region of the seventh cervical vertebra, the middle line is not retracted for figures with normal posture, for kinky figures it is retracted to the left by 0.3 - 0.5 cm, for stooped figures - to the right by 0.5 cm.

The abduction of the middle line of the back on the waist line depends on the silhouette of the product, the presence of darts at the waist, the seam in the middle of the back and the features of the figure.

Further construction of the midline of the back is carried out in the following order:

In products with a continuous (whole) back, point A 0 is connected by a straight line to point T 1 and continues until it intersects with the bottom level; the point of intersection with the line of the hips denote B 1;

In products with a split back (with a seam in the middle), point A 0 "is connected with a straight line to point U. Point U is connected with a straight line T 1 and continues to the bottom level; the middle line of the back in the upper part is drawn with a smooth line;

In products with a split back of semi-adjacent and adjacent silhouettes, an additional tuck is made on the waist line to increase the fit:

T 1 T 11 \u003d 1.0-1.5 cm.

The distance T 1 T 11 is divided in half, the resulting point is connected by a straight line with point B 1 the line is continued to the bottom line.

Points A 0 ", Y, T 11 and B 1 are connected by a smooth line.

The waist line is drawn at a right angle: for products with an average back seam - to UB 1 for products with a solid back - to A 0 B 1.

Back neckline. To the right of the point A 0 (A 0 ") lay a segment equal to the width of the neck of the back:

A 0 A 2 (A 0 "A 2) \u003d 1/3 Ssh + Psh.gs.

For figures with fatty deposits in the region of the seventh cervical vertebra or with developed muscles in the region of the shoulder girdle, the width of the neck of the back is increased by 0.5 - 1.0 cm. darts in the neck of the back, equal to 1.0-1.5 cm.

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Hello Katya.

The third position of the back on an ordinary stroller opens up "new horizons" for the baby, because in a sitting position it is convenient to look at the world around, everything becomes more accessible and interesting. However, it is not in vain that parents wonder when it is possible to start carrying a child in this position of the back, because setting the vertical position too early can harm the baby. In this matter, age restrictions and some rules, which will be discussed below, are of paramount importance.

At what age can the back of the stroller be set upright?

It does not matter what kind of stroller you have: a cradle, a transformer or a walking option - the backrests can be installed vertically in almost any model of strollers. However, before changing the position of the backrest, parents should take into account the state of development of the child's spine.

In the first months of a baby's life, a sitting position is out of the question, because. increased loads on a fragile spine can greatly harm the baby. 5 - 6 months is the minimum age for transplanting a baby into a sitting position. If you listen to the opinion of experts, then you need to change the back of the wheelchair at the moment when the baby has not only begun to sit, but can also spend a long time in this position. In the case when the child is just starting to sit, but does it extremely uncertainly, it is better to wait a month or two. The stability of the upright sitting position should serve as a signal to you that the backrest on the wheelchair can be set to the sitting position.

Why can't you change the back of the stroller prematurely?

Premature haste in this matter can lead to irreversible consequences for the development of the child's spine. Curvature of the spinal column is the most common disorder caused by setting the back of the wheelchair too early in the horizontal position. This argument is quite enough to wait 7 - 8 months from the date of birth of the crumbs before rushing to transform the stroller into a sitting position.

However, once again I draw your attention to the individual characteristics of the development of the child. Only 70% of children begin to sit at 6 months - some may not attempt until 7 months. Be sure to take this into account. Speaking on average, it is best to transfer the stroller to a sitting position after 1 - 2 months from the moment the position is stable.

As practice shows, most parents refuse conventional massive strollers, switching to strollers, which are more convenient and rational to use. When the time comes and you begin to select convenient options, then consider some important characteristics of such strollers:

• Manufacturer information. The manufacturer always indicates important information in the passport for the product. Nuances of operation, precautions, age restrictions, etc. - all this is prescribed by the manufacturer without fail.
• assembly mechanism. Strollers come in two types: book (heavier, but more stable) and cane (lighter, but less stable).
• Wheel cushioning. Try to choose options with large and elastic wheels. In such a stroller, the baby will not shake from the slightest pebbles and bumps in the track. It is generally better to refuse small plastic wheels.
• Back positions. Even in strollers, 4 backrest positions can be provided so that the baby rests after walking in a sitting position.
• Belts. Be sure to pay attention to seat belts and various restraints. This is the safety of your child, which should not be neglected in any case.

Sincerely, Natalia.