Fetal Malpresentation

Fetal Malpresentations

Abstract

Fetal malpresentation is defined by the American Heritage Medical Dictionary as “presentation of a part of a fetus other than the back of the head during parturition.” There are many forms of fetal malpresentation which will be discussed in the course of this paper along with diagnostic testing for malpresentations, complications and interventions that can be done to ensure delivery of the infant via either normal vaginal delivery or if need be by caesarean section. Although fetal malpresentations consist of many different types, which will be discussed in brief, the most common type of malpresentation, called a breech presentation, will be discussed at length.

Patient Demographics

The patient is an expectant mother, 42 years of age, Gravida 4 Para 3, 37 weeks pregnant with no contributing major illnesses who was admitted to hospital with uterine contractions. Patient was diagnosed with Polyhydroamnios at 15 and 20 week evaluation via prenatal ultrasonography. (Merlino, Chappa & Sherger, 2014). At time of admission patient had contractions 2 to 3 minutes apart with stage of labor at 4/90/-1 and amniotic sac rupture.

Patient History and Diagnosis

Patient was admitted to hospital at 37 weeks pregnant with uterine contractions. Patient has ultrasonography at 15 and 20 week mark due to suspected Polyhydroamnios after measurements were conducted prior via ultrasound. Testing confirmed that patient has mild asymptomatic Polyhydroamnios and patient had periodic scheduled appointments and testing with no respiratory distress to patient due to excessive amniotic fluid. Patient complained of epigastric reflux which was treated with antacids with relief of symptoms. Patient had ultrasound at 34 weeks which showed fetus in a complete breech position. Breech position confirmed by Leopold’s examination....