bubble_chart Concept

Malposition of the fetus refers to the abnormal position of the fetus in the mother's abdomen during the late stage of pregnancy [third stage]. It is also known as abnormal fetal position. Common types include breech position, transverse position, and posterior position. In ancient times, it was referred to as "inverted birth," "transverse birth," or "oblique birth."

Malposition of the fetus is one of the causes of difficult delivery. Therefore, if abnormal fetal position is detected after six or seven months of pregnancy, timely correction should be attempted to avoid difficult delivery during childbirth.

bubble_chart Pattern Analysis

1. Qi Stagnation︰Pregnancy late stage [third stage], abnormal fetal position. The body is often sallow and thin, with a faint bluish hue on the face, or chest tightness, discomfort and fullness in the upper abdomen, or severe fullness on one side, even chest and abdominal distension and fullness, rapid breathing, thin white tongue coating, and a fine slippery or slightly wiry pulse. It is mostly caused by depression and stagnation of qi movement, leading to hindered fetal repositioning. Symptoms may include a sallow and thin body, a faint bluish hue on the face, discomfort and fullness in the upper abdomen, and chest tightness. Treatment should focus on regulating qi and moving stagnation, nourishing blood to reposition the fetus, using the Baochan Wuyou prescription.
2. Spleen Deficiency with Dampness Retention︰Pregnancy late stage [third stage], abnormal fetal position. The body is relatively obese but the muscles are not firm, heavy body with weak strength, intolerance to fatigue, or epigastric fullness with poor appetite, or loss of appetite, or edema, tongue texture puffy and pale, pulse slippery and soggy. This is mostly due to spleen deficiency and dampness retention, affecting fetal rotation. Symptoms include obesity, heavy body with weak strength, or accompanied by edema, limb fatigue, etc. Treatment should focus on strengthening the spleen and draining dampness, nourishing blood and tonifying the kidneys to rotate the fetus. The recommended prescription is Modified Angelica and Peony Powder.
3. Deficiency of Both Qi and Blood︰pregnancy late stage [third stage], abnormal fetal position. Muscle wasting, or obesity without firmness, shortage of qi lack of strength, prone to fatigue, complexion pale, lips and tongue pale, pulse thin slippery and weak. Due to constitution weakness, qi and blood deficiency, inability to reposition. The key diagnostic points are characterized by emaciation, pale lips and tongue, shortage of qi lack of strength, and intolerance to fatigue. Treatment should focus on tonifying qi and nourishing blood to reposition the fetus, using Eight Precious Ingredients Decoction with Sichuan Twotooth Achyranthes Root and Submature Bitter Orange, or alternatively, the Fetal Repositioning Decoction may also be used.

Malposition of the fetus, according to clinical differentiation, is often associated with qi stagnation and spleen dampness. However, a significant number of patients, apart from the main symptom of fetal malposition, do not exhibit other obvious symptoms, making it difficult to determine whether it is caused by qi stagnation or spleen dampness. Clinical experience suggests that even in the absence of clear symptoms, treatment with the Baochan Wuyou formula or the modified Angelica and Peony Powder can often yield satisfactory results. Both formulas have the functions of regulating qi, dispelling dampness, and nourishing blood, but the former emphasizes qi regulation while the latter focuses on blood regulation. Therefore, they can be used as general treatments for fetal malposition due to qi stagnation and spleen dampness.

bubble_chart Documentation

1. Fuqingzhu Gynecology．Pre and Postpartum Conditions and Contraindications: "In cases of transverse presentation, the baby lies in the mother's womb with the head up and feet down. During delivery, the head should be downward. If the mother exerts force to push, the fetus may turn halfway and become transverse. The mother should be instructed to lie calmly on her back, allowing the baby to adjust naturally.…Chinese Angelica, Perilla Leaf, each three qian, boiled with long river water and taken will facilitate delivery."