Fetal malposition and malpresentation: Mode of delivery and perinatal outcomes at Maternity Teaching Hospital in Erbil city

Abstract

Background and objective: Delivering a malpositioned and malpresenting fetus remains uncertainty, despite advances in obstetric practice. This study aimed to determine the mode of delivery and neonatal outcome in cases of fetal malposition and malpresentation. Methods: A cross-sectional study of women delivering malpositioned and malpresenting fetuses was conducted at Maternity Teaching Hospital, Erbil city, Kurdistan Region, Iraq, from the 1st of June, to the 30th of November, 2018. Three hundred women and their newborns were followed for seven days of life. Results: The total rate of malposition and malpresentation was 4.8%. Most women (87.3%) delivered by cesarean section, 25% of the neonates were admitted to the neonatal intensive care unit, where 69.3% of these infants stayed for seven days. There were three early neonatal deaths (1.0%), all of them were in occipito-posterior, or occipito-transverse position and were delivered abdominally. Among occipito-posterior and occipito-transverse deliveries, 2.2% ended with the death of the fetus (P = 0.360). An Apgar score of 7 was recorded after 5 minutes for 97.7% of the infants. Around 11% of the women had postpartum hemorrhage. Conclusion: Fetal malpresentation and malposition are not uncommon during labor, and most cases are delivered by cesarean section. Neonatal morbidity and mortality are dependent on the type of presentation and the mode of delivery. Keywords: Malposition; Malpresentation; Perinatal outcome; Breech presentation.