MALPRESENTATION- INCIDENCE AND CAUSES
Journal Title: Journal of Evolution of Medical and Dental Sciences - Year 2018, Vol 7, Issue 2
Abstract
BACKGROUND Malpresentation is defined as when the presenting part of foetus is other than normal vertex of foetal head. It includes breech, face, brow, shoulder, compound and cord presentations. In modern obstetrics, the incidence of malpresentation has fallen due to reducing parity. Among malpresentations, breech presentation is the most common. The aim of this study is to study the incidence, aetiological factors and foetomaternal outcome. MATERIALS AND METHODS A retrospective study of malpresentation was conducted in Obstetrics and Gynaecology Department for a period of 5 years from 1st January 2012 to 31st December 2016 at MGMMCH, Jamshedpur, Jharkhand. The incidence, aetiological factors and foetomaternal outcome were discussed. RESULTS There were 28,431 deliveries conducted with 1099 malpresentations with an incidence of 3.87%. Out of these, 1099 (3.87%) patients presented with malpresentation. Commonest malpresentation was breech (2.85%) followed by transverse lie (0.60%), face presentation (0.23%), compound presentation (0.08%), cord presentation (0.07%) and brow presentation (0.04%). Most of these are unbooked cases, 692 (62.97%). In the present study, 45.38% occurred in primigravidae. Breech was the most common malpresentation, 334 (41.18%) cases were delivered by vaginal route. In the present study, 34 (3.09%) cases with malpresentations delivered anomalous babies. Prematurity was the aetiological factor accounting to 7.92% of the cases, 25.93% accounted to multiparity, 2.47% presented with uterine anomalies and 4.64% contracted pelvis, 3.10% presented with disorders of amniotic fluid volume and 1.09% cases had placenta previa and 6.39% accounting to twins. 15.37% babies were still birth associated with malpresentation and neonatal death was seen in 7.10%. The commonest cause of still birth is prematurity, transverse lie with hand prolapse. CONCLUSION Malpresentation requires high vigilance and prompt management to reduce perinatal mortality and maternal morbidity.
Authors and Affiliations
Anjali Srivastava, Manjula Srivastava, Preeti K. M
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