Mal Presentations

Malpresentation refers to when your baby is in an unusual position as the birth approaches.

The common complications of malpresentation or malposition of the fetus at full term include:

  • Premature rupture of membranes
  • Premature labour
  • Prolonged/obstructed labour
  • Ruptured uterus
  • Postpartum haemorrhage
  • Fetal and maternal distress which may lead to death.

Common causes of malpresentations/malpositions include:

  • Excess amniotic fluid
  • Abnormal shape and size of the pelvis
  • Uterine tumor
  • Placenta praevia
  • Slackness of uterine muscles (after many previous pregnancies)
  • Multiple pregnancy.
  • Prematurity
  • Multiple pregnancy
  • Abnormalities of the uterus - fibroids.
  • Partial septate uterus.
  • Abnormal fetus.
  • Placenta praevia.
  • Primiparity

On abdominal examination, the head is felt in the upper abdomen and the breech in the pelvic brim. Auscultation locates the fetal heart higher than expected with a vertex presentation. On vaginal examination during labour, the buttocks and/or feet becomes thick, dark meconium is normal.

It may be possible to correct the malpresentation by gently turning the baby into a head-first position. This is done by an obstetrician using a technique called external cephalic version (ECV).

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