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Study and Outcome of Various Malpresentations

Madhura Prakash Pophalkar , Fasiha Tasneem1 , Madhura Prakash Pophalkar2

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Indian Journal of Obstetrics and Gynecology 7(2):p 147-157, April-June 2019. | DOI: http://dx.doi.org/10.21088/ijog.2321.1636.7219.5

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Fasiha Tasneem, Madhura Prakash Pophalkar. Study and Outcome of Various Malpresentations. Indian J Obstet Gynecol. 2019;7(2):147-157.

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Abstract

This study aimed to evaluate outcome of various malpresentations at the teritary care centre. There are various causes of maternal and perinatal morbidity and mortality with neglected and mismanaged malpresentation being one. This prospective study was carried out at tertiary care center and teaching institute in the Department of Obstetrics and Gynecology over a period of 18 months. During this period 384 cases of malpresentations were delivered. Out of which 134 delivered vaginally and 246 by caesarean section. Majority of cases i.e. 86% were breech presentation, 8.2% were transverse lie,. 4.2% face presentation. Of the 328 cases of breech 49% were complete breech. 89.4% cases were in full term group which had good fetal outcome. 97% of cases out of 65.6% cases that were delivered by caesarean section had good fetal outcome. Our study states that breech presentation is the commonest type of malpresentation and though caesarean section yields better perinatal outcome, we can conclude that vaginal breech delivery is also safe with good maternal and fetal outcomes. Transverse lie and brow presentation are conditions that poses significant clinical challenge, both in terms of perinatal and maternal survival. Thus early diagnosis followed by caesarean delivery are likely to give better clinical outcome. The corner stone of proper management of malpresentations lies in provision of good antenatal care and maternal and fetal outcome can be improved by early diagnosis. Delivery in cases of breech and face presentation should be conducted in hospital with well equipped caesarean facilities and skilled obstetrician because once it becomes neglected then the maternal and fetal outcome is poor.

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Cite this article

Fasiha Tasneem, Madhura Prakash Pophalkar. Study and Outcome of Various Malpresentations. Indian J Obstet Gynecol. 2019;7(2):147-157.

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DOI: http://dx.doi.org/10.21088/ijog.2321.1636.7219.5

Keywords

AJOG - American Journal Obstetrics and Gynaecology; CTG - Cardiotocography; IUFD - Intrauterine fetal demise; NCBI - National Centre for Biotechnology Information; PROM - Premature rupture of membrane; Z-A - Zatuchni Andros score.

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