CONDITION OF NEWBORNS AFTER BREECH DELIVERY

Stav zatkom je nepravilnost stava kod kojeg je glavica u fundusu uterusa, a predleţeća ĉest je zadak. Postoje jednostavan stav zatkom, potpuni stav zatkom, nepotpuni stav zatkom, koljeni stav zatkom i stav zatkom noţicama. Kod stava zatkom treba gotovo uvijek posumnjati na nepravilnosti zdjelice, fetusa ili maternice. Stav zatkom ĉešto se javlja kod prijevremenih poroda jer fiziološki okret nije dovršen. Dijagnoza se postavlja anamnestiĉkim podacima trudnice o fetalnim pokretima, amnioskopijom, vanjskom opstetriĉkom pretragom ,unutarnjim opstetriĉkim pregledom i ultrazvukom. Prije odluke o naĉinu dovršenja poroda, iskusni opstetriĉar moţe predloţiti rodilji vanjski okret. Mehanizam poroĊaja kod stava zatkom vaţno je dobro znati da bi se znalo pravilno voditi porod. Za vaginalni poroĊaj rodilja mora imati dobre trudove, prostranu zdjelicu i dijete normalne veliĉine u donosu na gestaciju i graĊu trudnice. Nerijetko se mora posezati za ruĉnim pomoćima kod komplikacija poroĊaja na zadak. Najĉešće je to ruĉna pomoć po Brechtu, klasiĉno oslobaĊanje ruĉica, oslobaĊanje ruĉica po Mulleru i ruĉna pomoć po Veit- Smelie. S obzirom na sve poznate rizike i komplikacije koje sa sobom nosi stav zatkom, zadnjih tridesetak godina povećava se broj carskih rezova kod takvih poroda, te se najĉešće porod dovršava elektivnim carskim rezom u terminu. Rizici i komplikacije kod stava zatkom posljedica su patoloških stanja koja mogu izravno ili posredno utjecati na nastanak spomenutog stava i opstetriĉkih intervencija. Rizici u porodu su povećani ponajviše zbog nekonfigurirane fetalne glavice koja se poraĊa zadnja u nizu i zbog kompresije pupkovine kod poraĊanja trupa. Stanja ugroţenosti novoroĊenĉeta nakon poroĊaja kod stava zatkom su poroĊajne ozljede, fetalna hipoksija s asfiksijom i acidozom te prematuritet. Ĉešća su displazija kukova, pogotovo kod novoroĊenĉadi koja su bila u jednostavnom stavu zatkom.A breech presentation is an irregularity of the presentation where the fetus head is in the uterus wall, and the predominant common is breech. There is a simple breech presentation, a complete breech presentation, an incomplete breech presentation, a knee breech presentation, and footling breech presentation. It is almost always necessary to suspect irregularities in the pelvis, the fetus or the uterus when it comes to the breech presentation. Attempts often occur in premature labor because the physiological rotation is not over. The diagnosis is based on anamnestic data of pregnant women on fetal movements, amnioscopy, external ophthalmic examination, internal ophthalmic examination and ultrasound. Prior to deciding on the way of completing the child's birth, an experienced obstetrician may suggest aexternal cephalic version. It is important to know the birth mechanics of a baby's holding to know how to properly give birth. For vaginal delivery, the mother has to have good contractions, a large bowl and a normal size fetus in gestation and pregnancy. It often has to be handled for manual assistance. Most commonly, this is manual assistance by Brecht, classic release of the hands, release of the lever on Muller and manual assistance by Veit-Smelie. Considering all the known risks and complications with which attending a breech presentation, the number of caesarian section in such births has increased for the last thirty years, and most often s delivery ending with an elective caesarian section on the term. Risks and complications in breech presentation are the consequence of pathological conditions that can directly or indirectly affect the emergence of the obstetrical interventions. The risk of birth is increased mainly due to the unconfigured fetal head which is crowned in the last row and because of the compression of the umbilical cord at the hull. Conditions of newborn infirmity after delivery are birth injury, fetal hypoxia with asphyxia and acidosis, and premature birth. Swelling of the hips is more common, especially in infants who were in a simple breech delivery