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    Malposition/Malpresentation: DR - Nagina Bibi Ap Obgyn CMC

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    Ali Sohail
    This document defines malposition and malpresentation in childbirth and discusses the various types. Malposition refers to abnormal positions of the fetal head relative to the maternal pelvis, such as occipito-posterior. Malpresentation is when the fetal presentation is not cephalic, such as breech. The most common types of malposition/malpresentation are discussed, including occipito-posterior, breech, and transverse lie. Risk factors and management approaches are also outlined.

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    Malposition/Malpresentation: DR - Nagina Bibi Ap Obgyn CMC

    Uploaded by

    Ali Sohail
    42 views27 pages
    This document defines malposition and malpresentation in childbirth and discusses the various types. Malposition refers to abnormal positions of the fetal head relative to the maternal pelvis, such as occipito-posterior. Malpresentation is when the fetal presentation is not cephalic, such as breech. The most common types of malposition/malpresentation are discussed, including occipito-posterior, breech, and transverse lie. Risk factors and management approaches are also outlined.

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    Mal Position

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    This document defines malposition and malpresentation in childbirth and discusses the various types. Malposition refers to abnormal positions of the fetal head relative to the maternal pelvis, such as occipito-posterior. Malpresentation is when the fetal presentation is not cephalic, such as breech. The most common types of malposition/malpresentation are discussed, including occipito-posterior, breech, and transverse lie. Risk factors and management approaches are also outlined.

    Copyright:

    © All Rights Reserved
    Download as PPTX, PDF, TXT or read online from Scribd
    Download as pptx, pdf, or txt
    42 views27 pages

    Malposition/Malpresentation: DR - Nagina Bibi Ap Obgyn CMC

    Uploaded by

    Ali Sohail
    This document defines malposition and malpresentation in childbirth and discusses the various types. Malposition refers to abnormal positions of the fetal head relative to the maternal pelvis, such as occipito-posterior. Malpresentation is when the fetal presentation is not cephalic, such as breech. The most common types of malposition/malpresentation are discussed, including occipito-posterior, breech, and transverse lie. Risk factors and management approaches are also outlined.

    Copyright:

    © All Rights Reserved
    Download as PPTX, PDF, TXT or read online from Scribd
    Download as pptx, pdf, or txt
    of 27

    MALPOSITION/MALPRESENTATION

    Dr.Nagina bibi
    Ap ObGyn
    CMC
    Definition
    • Position – the relationship of specific point on presenting
    part to maternal pelvis.(occiput,sinciput)
    • Usually the fetal head engages in the occipito-anterior
    position (the fetal occiput facing anteriorly) – this is ideal
    for birth
    • Other positions include occipito-posterior and occipito-
    transverse.
    • Malpositions are abnormal positions of the vertex of the
    fetal head (with the occiput as the reference point) relative
    to the maternal pelvis.
    Malpresentation
    • Malpresentation is a presentation that is not cephalic.
    • Breech presentation
    • oblique and transverse positions
    • Breech presentation
    • the most commonly encountered malpresentation
    • occurs in 3–4% of term pregnancies,
    • oblique and transverse positions are not uncommon
    antenatally.
    • They only become a problem if the baby is not cephalic
    by 37 weeks’ gestation.
    Risk Factors
    • Maternal factors:
    • Contracted pelvis
    • pelvic tumour /
    • fibroid uterus
    • uterine anomaly (arcuate or septate )
    • placenta praevia
    • Foetal factors:
    • Prematurity
    • Oligohydramnios/polyhydramnios
    • fetal malformation e.g. hydrocephalus
    • intrauterine death
    Types of malposition/malpresentations
    • Occipito posterior(right,left)
    • Occipito transverse(right,left)
    • Face(mentoanterior,mento posterior)
    • Brow
    • Breech
    • frank,
    • flexed,
    • half
    • Transverse lie with shoulder presentation
    OCCIPITO POSTERIOR
    • Labour is prolonged
    • Patient complains of labour pain which is at the back.
    • On vaginal examination occiput is felt in posterior half of
    pelvis(posterior fontanelle,triangular)
    • In advanced labour with severe moulding fetal ear pinna
    can be felt to assess fetal position in experienced hands.
    • Fetus deliver as
    • occipito anterior,
    • Spontaneous occipito posterior,
    • assitsed vaccume delivery or forceps delivery
    • cs
    Face presentation
    • Very rare
    • Fetal chin (mentum)is denominator
    • Mento anterior or mento posterior
    • Diffentiate from breech presentation in labour
    • Mento posterior does not deliver ,need cs
    • Mento anterior deliver with small presenting diameter
    9.5cm ,submentobregmatic,chin act as fulcrum at
    subpupic arch ,
    Brow presentation
    • Deflexed head with largest diameter mentovertical is
    presenting
    • Either it extend furthur into face presentation
    • If it persist there is no descent of presenting part,and
    leads to obstructed labour.
    • Caesren section
    Transverse lie/Oblique lie
    • A transverse lie occurs when the fetal long axis lies
    perpendicular to that of the maternal long axis and
    classically results in a shoulder presentation.
    • An oblique lie occurs when the long axis of the fetal body
    crosses the long axis of the maternal body at an angle
    close to 45°.
    • Any woman presenting at term with a transverse or
    oblique lie is at potential risk of cord prolapse following
    spontaneous rupture of the membranes, and prolapse of
    the hand, shoulder or foot once in labour.
    Transverse lie/Oblique lie
    • No mechanim of labour exist
    • Untreated result in
    • obstructed labour
    • ,iud,
    • rupture uterus
    • pph
    • ,maternal death
    • Management
    • elective caesarean section at term
    • stabilizing induction with manual rotation through maternal
    abdomen and followed by augmented labour
    Reference
    • Obstetrics by ten teachers 20th Edition

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