№ 38Obstetrics15 min read
Malpresentations
1. Big picture
Malpresentation means the fetus presents to the birth canal with something other than the normal well-flexed vertex. It matters because malpresentation increases the risk of:
- Obstructed labour
- Umbilical cord prolapse
- Fetal hypoxia
- Birth trauma
- Uterine rupture
- Emergency caesarean section
- Postpartum haemorrhage
The normal presentation is:
Longitudinal lie
↓
Cephalic presentation
↓
Well-flexed vertex
↓
Occipito-anterior position
Anything outside this pattern should make you ask:
Can this fetus safely pass through the pelvis vaginally?
Is the fetal head flexed or extended?
Is the lie longitudinal or transverse?
Are membranes ruptu
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