Malpositions and malpresentations of the foetal head (original) (raw)
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Malpositions and malpresentations of the fetal head
Obstetrics, Gynaecology & Reproductive Medicine, 2012
In normal labour, the fetal head presents with the occiput in lateral position in early stages of labour followed by anterior rotation in advanced labour. Malpositions of fetal head result when the occiput persists in a lateral or posterior position while malpresentations occur due to extension of the fetal head causing brow or face to present. Malpresentations of fetal head are usually diagnosed in labour and are associated with difficult labour and increased risk of operative intervention. Regular systematic clinical examinations to monitor progress of labour and fetal wellbeing are necessary once the diagnosis is confirmed. Although vaginal delivery is possible in many cases, caesarean section becomes necessary when the malposition or malpresentation persists and labour fails to progress.
Fetal malpositions and malpresentations in labour
Obstetrics Gynaecology & Reproductive Medicine
In normal labour, the fetal head presents with the occiput in lateral posi-tion in early stages of labour followed by anterior rotation in advanced labour. Malpositions of fetal head result when the occiput persists in a lateral or posterior position while malpresentations occur due to exten-sion of the fetal head causing brow or face to present. Malpresentations of fetal head are usually diagnosed in labour and are associated with diffi-cult labour and increased risk of operative intervention. Regular system-atic clinical examinations to monitor progress of labour and fetal wellbeing are necessary once the diagnosis is confirmed. Although vaginal delivery is possible in many cases, caesarean section becomes necessary when the malposition or malpresentation persists and labour fails to progress.
Management of delivery when malposition of the fetal head complicates the second stage of labour
The Obstetrician & Gynaecologist, 2015
Second stage caesarean section (CS) is associated with greater maternal and neonatal morbidity and second stage CS rates are rising. Malposition of the fetal head is the most common indication for CS in the second stage of labour. Rotational vaginal deliveries are high risk obstetric procedures requiring advanced operator expertise and are associated with increased rates of failure. Currently, there are no UK guidelines for performing, training and documentation of rotational vaginal deliveries. The Royal College of Obstetricians and Gynaecologists' training matrix advises trainees to be competent at rotational ventouse before commencing specialist training year 6 and does not mention any other methods of rotational vaginal delivery. Learning objectives To learn how to manage fetal malposition in the second stage of labour. To identify appropriate maternal and fetal factors for trials of rotational instrumental vaginal delivery. To understand the requirement for national guidelines for documentation and training. Ethical issues Is exclusion of Kielland forceps and manual rotation in the current training matrix deskilling the future workforce? Is 24-hour consultant presence on the labour ward a practical solution to promote training and increase success rates in rotational vaginal deliveries? Can the use of training mannequins replace or reduce the length of appropriately supervised hands-on practice?
Zanco Journal of Medical Sciences, 2020
Background and objective: Delivering a malpositioned and malpresenting fetus remains uncertainty, despite advances in obstetric practice. This study aimed to determine the mode of delivery and neonatal outcome in cases of fetal malposition and malpresentation. Methods: A cross-sectional study of women delivering malpositioned and malpresenting fetuses was conducted at Maternity Teaching Hospital, Erbil city, Kurdistan Region, Iraq, from the 1st of June, to the 30th of November, 2018. Three hundred women and their newborns were followed for seven days of life. Results: The total rate of malposition and malpresentation was 4.8%. Most women (87.3%) delivered by cesarean section, 25% of the neonates were admitted to the neonatal intensive care unit, where 69.3% of these infants stayed for seven days. There were three early neonatal deaths (1.0%), all of them were in occipito-posterior, or occipito-transverse position and were delivered abdominally. Among occipito-posterior and occipito-...
Birth delivery trauma and malocclusion
Journal of Clinical Pediatric Dentistry, 2005
The aim of the investigation was to determine the dynamic of birth delivery and relate to dental occlusion among a group of adult subjects. The group studied was made up of 106 subjects (57 females and 49 males) referred for dental diagnosis and treatment. The average age was 26 with a range 22 to 30 years. In data collection and analysis the following were used as measures: dental occlusion (Angle Class I, II div 1, II div 2 and III) and type of delivery (normal, short, long, caesarean and other). Results showed that among 106 subjects 72 (68%) had malocclusion versus 34 (32%) with normal occlusion; 24 subjects (22.6%) have been normal delivery versus 82 (77.4%) with non-normal delivery. Class I is present in 34 subjects (32%), class II division 1 in 26 (24%), class II division 2 in 22 (20%), class III in 16 (14%), and 8 subjects (6%) fall in the section "other". Among 24 subjects with normal delivery 100% presented class I occlusion. However, among 82 subjects with non-n...
A study of gross congenital malformation at birth
International Journal of Contemporary Pediatrics
Background: A congenital anomaly is a structural anomaly of any type that is present at birth. Congenital anomalies may be induced by genetic or environmental factors. Most congenital anomalies, however, show the familial patterns expected of multi-factorial inheritance. The aims and objective of this study were to study the incidence of visible congenital malformations at birth, to study risk factors, to find associated internal malformations.Methods: It is a retrospective cross-sectional study carried out in a tertiary care hospital affiliated to a medical college. The Inclusion criteria include all new-borns delivered in the hospital with visible congenital malformations examined within 48 hours of birth. Extramural babies were included if they had presented within 48 hours after birth. The Exclusion criteria include still births were excluded from the study.Results: Percentage of congenital malformation was 1.32%. Most common systems involved were musculoskeletal system (46.34%)...
Study of incidence and outcome of structural malformed foetus in delivered patients
IP innovative publication pvt. ltd, 2019
Introduction: Congenital fetal anomalies are one of the most threatening complications which are prevalent in the society associated with severe morbidity and mortality in the newborn foetus. Congenital anomalies account for 8% to 15% of perinatal deaths and 13% to 16% of neonatal deaths in India. The etiology of congenital abnormality may be genetic or environmental. Aim and Objective: The present study was carried out with the aim to determine the overall incidence and outcome of congenital structural malformations in delivered patients, to identify the most common structural anomaly and study the socio-demographic correlates with structural anomalies and compared them to previous studies. Materials and Methods: The study was conducted on all obstetrics patients with concent who have delivered with fetal congenital malformations in Medical College Pune, Maharashtra over a period of 2 year satisfying inclusion and exclusion criteria. The questionnaire was prepared included the information regarding mothers age, gender birthweight, religion and socioeconomic, past and personal history was included. Data management and analysis was done using Epi-info software. The frequency distribution and graph was prepared. The categorical variables was assessed using Pearson chi-square. Results: It was observed that the overall incidence of structural malformed foetus delivered came out to be 1.2%. Low Birth weight, Low socio economic status and female gender of child are commonly involved in congenital structural malformations. There was no significant association observed between system involved with gender of child, gestational age or history of abortion. The most common anomaly found is related to GIT followed by the Genitourinary. Conclusion: We conclude that gastrointestinal, genitor-urinary, cardiovascular and nervous systems are commonly involved in congenital structural malformations. Among the gastro-intestinal system congenital hypertrophic pyloric stenosis and Anorectal malformations are the commonest ones. However Low Birth weight, Lower socio economic status and female gender of child are commonly involved in congenital structural malformations.
Zenodo (CERN European Organization for Nuclear Research), 2023
Background: Developmental Dysplasia of the Hip (DDH) is one of the most common congenital musculoskeletal problems in newborns. Its incidence varies in different populations and multiple risk factors have been reported Objectives:To determine the prevalence of developmental dysplasia of the hip (DDH) in newborns who had malposition and malpresentation at the time of delivery and to identify the presence of any other risk factors. Methods: A cross-sectional study was conducted on 507 Kurdish women who had fetal malpresentation and malposition during labor at the Maternity Teaching Hospital, Erbil city, Kurdistan Region. Ultrasound of the newborn's pelvis was conducted within 14 days of delivery and the Graf ultrasound method was used to screen for DDH. Results: The prevalence of DDH was 6.5 %. No significant associations were detected between the prevalence of DDH and the gestational age, parity, family history of DDH, mode of delivery, and amniotic fluid volume or any categories of mal-presentation. Conclusions: The rate of DDH is considerably high among a sample of Kurdish ethnicity neonates. There are no relative risk factors for its development.