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In this article, we will look at the risk factors, examination and management of abnormal fetal lie, malpresentation and malposition. Note: Breech presentation is the most common malpresentation, and is covered in detail here. The risk factors for abnormal fetal lie, malpresentation and malposition include:. The fetal lie and presentation can usually be identified via abdominal examination. The fetal position is ascertained by vaginal examination. For more information on the obstetric examination, see here. The fetal lie and presentation may not be possible to identify if the mother has a high BMI, if she has not emptied her bladder, if the fetus is small or if there is polyhydramnios. During labour, vaginal examination is used to assess the position of the fetal head in a cephalic vertex presentation. The landmarks of the fetal head, including the anterior and posterior fontanelles, indicate the position. Any suspected abnormal fetal lie or malpresentation should be confirmed by an ultrasound scan. This could also demonstrate predisposing uterine or fetal abnormalities. If the fetal lie is abnormal, an external cephalic version ECV can be attempted — ideally between 36 and 38 weeks gestation. Complications of ECV are rare but include fetal distress , premature rupture of membranes, antepartum haemorrhage APH and placental abruption. The risk of an emergency caesarean section C-section within 24 hours is around 1 in If the fetal head does not rotate, rotation and operative vaginal delivery can be attempted. Alternatively a C-section can be performed. If the fetal lie is abnormal, an external cephalic version ECV can be attempted - ideally between 36 and 38 weeks gestation. Transverse fetal lie. Accessed July 24, Frequently asked questions. Pregnancy FAQ If your baby is breech. American College of Obstetricians and Gynecologists. Gabbe SG, et al. Normal labor and delivery. In: Obstetrics: Normal and Problem Pregnancies. Philadelphia, Pa. Accessed July 31, Multiple pregnancy. Cunningham FG, et al. Williams Obstetrics. New York, N. Chasen ST, et al. Twin pregnancy: Labor and
- delivery. Hofmeyr GJ. Overview of issues related to breech presentation.
Holcroft Argani C, et al. Occiput posterior position. Mayo Clinic Marketplace Check out these best-sellers and special offers on books and newsletters from Mayo Clinic. Reprint Permissions A single copy of these materials may be reprinted for noncommercial personal use only.
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That doesn't always happen, though. Check out some of the possible fetal presentations and positions at the end of pregnancy and find out how they can affect delivery. Mayo Clinic does not endorse companies or products. Advertising revenue supports our not-for-profit mission. Any use
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