Ld

Fetal Malpresentation

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Fetal Malpresentation

  • Precautions
  1. Avoid Oxytocin in most malpresentations except
    1. Occiput Posterior
    2. Twin Vaginal Delivery
  2. Consider Terbutaline SC before Cesarean Section
  3. Consider maternal position changes
  • Presentations
  1. Occiput Posterior (10%)
    1. Vaginal Delivery
  2. Face Presentation (<0.2% or 1 in 550 live births; full extension of fetal head, occiput against upper back)
    1. Mentum Anterior or Face Anterior
      1. Vaginal Delivery
    2. Mentum Posterior or Face Posterior
      1. Cesarean Section
    3. Brow (0.02%) and not converted to face or occiput
      1. Vaginal Delivery
  3. Compound Presentation (<0.5%)
    1. Vaginal Delivery
  4. Transverse Presentation (0.3%):
    1. Obstetric Ultrasound
    2. Attempt External Cephalic Version
    3. Cesarean Section for failed version
      1. Consider uterine vertical incision