Parto podalico
Si definisce parto podalico quello nel quale il bambino è rivolto verso il canale vaginale non con la testa (posizione cefalica), ma con i piedi. Normalmente, il feto verso il settimo o l’ottavo mese si gira assumendo appunto la posizione cefalica, ma in questo caso non lo fa. Se il feto resta seduto, rannicchiato su se stesso con le natiche rivolte verso il basso e le gambe incrociate, si parla di posizione podalica completa. Se le gambe sono tese e i piedi rivolti in basso, invece, si parla di posizione podalica incompleta. Ma perché il bambino non si gira nella posizione corretta? Le possibili cause sono:
- parto prematuro,
- parto gemellare,
- il piccolo invece di piegare le gambe le ha distese e ha quindi difficoltà a girarsi,
- il liquido amniotico è insufficiente oppure troppo,
- l’utero è troppo stretto o deformato.
Parto podalico: cesareo o naturale?
Di solito, in caso di posizione podalica del bambino si opta per un parto cesareo, perché la pressione esercitata sul collo dell’utero dalle natiche non è la stessa di quella della testa, quindi la dilatazione è minore e l’espulsione difficoltosa. In alcuni casi, però, il ginecologo può praticare alcune manovre per cercare di far spostare il bambino nella posizione corretta e fare un parto naturale. Le manovre consistono nell’esercitare delle spinte sul pancione della mamma per far muovere il bambino. Tali manovre, però, hanno solo il 50% di possibilità di successo e sono possibili solo se il bambino è in posizione podalica completa, se non è troppo grosso e se il bacino della mamma è abbastanza largo. In caso di posizione podalica incompleta, invece, bisogna optare necessariamente per un cesareo, che si programma tra la 39esima e la 40esima settimana.
Parto podalico naturale: rischi
Come si può facilmente intuire, il parto podalico naturale presenta diversi rischi, sia durante le manovre effettuate dal ginecologo per spingere il bambino a muoversi, sia durante il parto vero e proprio. Le manovre, infatti, possono provocare lo scollamento della placenta e far iniziare in anticipo il travaglio. Nella fase dell’espulsione, poi, se il bambino non si gira nella posizione corretta, ovvero quella cefalica, la mamma può andare incontro a delle lacerazioni e può essere necessario praticare l’episiotomia (l’incisione del perineo). Ovviamente, nel caso in cui la madre non riuscisse a espellere il piccolo in maniera naturale, nonostante le manovre e l’episiotomia, il medico può decidere di passare ad un taglio cesareo.
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