Malpresentation
By
Asmaa kadhim
Causes of malpresentation
Diagnosis
Abdominal examination
Vaginal examination
Mechanism of labour
Delivery of the head
12*12 cm and should therefore the 13 cm brow will not usually be able to pass the
midpelvis
Abnormal lie
Abnormal lie
• Transverse , oblique. And. Unstable lie
• Causes
• As mentioned above for malpresentation
• Diagnosis
• Abdominal exam small for date uterus , head mobile and felt on one side , no
presenting part on pelvic grip
• Vaginal exam Scapula , ribs may be felt ,or no presenting part
• Management
• Antepartum Conservative if preterm for spontaneous version
• ECV at term
• For unstable lie ECV and stabilized induction at term
• Intrapartum. Early labour and intact membrane . ECV
• Ruptured membrane or advanced labour ---- CS ( classical ??(
•
Cord presentation and cord prolaps
Causes and risk factors
Management of cord prolaps
• Depend on
• Viability of fetus
• Cervical dilatation at the time of diagnosis
• Fetal presenting part
• Dead fetus Allow vaginal delivery When there is no contraindication
• Viable fetus
• Fully dilated cervix and cephalic presentation ----- instrumental delivery
• Cervix not fully dilated ---- emergency CS after initial measures
•
• Cord presentation. Delivery should be by cesarean section
Measures to relive pressure on the cord
