What is the difference between Malpositions and Malpresentations?

Malpositions are abnormal positions of the vertex of the fetal head relative to the maternal pelvis. Malpresentations are all presentations of the fetus other than vertex.

What are the causes of malpresentation and malposition?

Common causes of malpresentations/malpositions include: excess amniotic fluid, abnormal shape and size of the pelvis; uterine tumour; placenta praevia; slackness of uterine muscles (after many previous pregnancies); or multiple pregnancy.

What are the types of malpresentation?

There are different types of malpresentation:

• Breech presentation: A breech presentation is when the baby is lying with their bottom or feet down.
• Transverse lie: A transverse lie is when the baby is lying sideways.
• Oblique lie: The baby’s head is against the mother’s hip, high above the birth canal.

What is the most common cause of fetal malpresentation?

Risk factors for fetal malpresentation

• Multiparity (which can result in lax abdominal walls)
• Multiple gestations (e.g., twins)
• Prematurity.
• Uterine abnormalities (e.g., leiomyomas, uterine septa)
• Narrow pelvis.
• Fetal anomalies (e.g., hydrocephalus.
• Placental anomalies (e.g., placenta previa.
• Amniotic fluid.

What is Sinciput presentation?

Definition. A fetal position during delivery in which the frontal part of the skull including forehead and the top of the head is first to descend into the birth canal. [ from NCI]

What does Malpositioned mean?

: wrong or faulty position.

How is malpresentation diagnosed?

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 are felt; thick, dark meconium is normal.

What is the most common malpresentation?

Types

• fetal malpresentations types include 1,3,4 breech – most common malpresentation; buttocks or feet of fetus are fetal presenting part.
• fetal malposition types include 2,3 occiput posterior – fetal occiput is oriented toward the posterior aspect of the maternal pelvis.

How can malpresentation be prevented?

II. Precautions

1. Avoid Oxytocin in most malpresentations except. Occiput Posterior. Twin Vaginal Delivery.
2. Consider Terbutaline SC before Cesarean Section.
3. Consider maternal position changes.

What is sinciput and occiput?

The front of the skull from the forehead to the crown. ‘The bregma, forehead, nose, mouth, and chin are born in succession as the sinciput sweeps along the sacrum. ‘ ‘When there is extension, the occiput is higher than the sinciput and the occiput is the cephalic prominence. ‘

What is occiput presentation?

In occiput posterior presentation (also called sunny-side up), the fetus is head first but is facing up (toward the mother’s abdomen). It is the most common abnormal position or presentation.

What is the most common fetal malposition?

How many types of fetal presentations are there?

The different fetal positions include occiput anterior position (OA), occiput posterior (OP) position, occiput transverse (OT) position, and 3 types of breech positions. The relationship between your baby’s backbone and your backbone when your baby is in-utero is called the fetal position.

Can macrosomia cause malpresentation?

Macrosomia and shoulder dystocia Potential complications of macrosomia include malpresentation, operative vaginal delivery, shoulder dystocia, caesarean section, PPH, perineal trauma, low Apgar scores, and admission to NICU [29,58].

What is Sinciput of skull?

1 : forehead. 2 : the upper half of the skull.

What are the complications of Occipito posterior position?

Complications of the occiput posterior position The OP position is associated with more frequent induction and augmentation of labour and prolonged first and second stage of [3,17,18,21], chorioamnionitis, post-partum haemorrhage, third and fourth degree perineal tears, wound infection and endometritis [22,23].

What are the three main fetal presentations?

Classification

• cephalic presentation (head first): vertex (crown)—the most common and associated with the fewest complications. sinciput (forehead)
• breech presentation (buttocks or feet first): complete breech.
• shoulder presentation: arm.
• compound presentation—when any other part presents along with the fetal head.

What is occiput posterior presentation?

Occiput Posterior (OP) In occiput posterior position, your baby’s head is down, but it is facing the mother’s front instead of her back. It is safe to deliver a baby facing this way. But it is harder for the baby to get through the pelvis.

What are malpositions and malpresentations?

Malpositions are abnormal positions of the vertex of the fetal head (with the occiput as the reference point) relative to the maternal pelvis. Malpresentations are all presentations of the fetus other than vertex. PROBLEM The fetus is in an abnormal position or presentation that may result in prolonged or obstructed labour.

What are the predisposing factors for malpresentation?

Predisposing factors to malpresentation include: 1 Prematurity. 2 Multiple pregnancy. 3 Abnormalities of the uterus – eg, fibroids. 4 Partial septate uterus. 5 Abnormal fetus. 6 Placenta praevia. 7 Primiparity.

What are the movements of the occiput?

The occiput escapes under the symphysis pubis and the head is crowned. Extension. The sinciput, face and chin sweep the perineum and the head is born by a movement of extension. Restitution. The occiput turns one-eighth of a circle to the right and the head realigns itself with the shoulders. Internal rotation of the shoulders.

What is the position of the sinciput and occiput during birth?

The sinciput reaches the pelvic floor first and rotates forwards. The occiput goes into the hollow of the sacrum. The baby is born facing the pubic bone (face to pubis). There is slow descent with a deflexed head and fetal heart audible in the flank or in the midline. Delay is common.

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