Open AccessMalpresentations – impact on mode of delivery
Author(s) -
GARDBERG MIKAEL,
LEONOVA YANA,
LAAKKONEN EERO
Publication year - 2011
Publication title -
acta obstetricia et gynecologica scandinavica
Language(s) - English
Resource type - Journals
SCImago Journal Rank - 1.401
H-Index - 102
eISSN - 1600-0412
pISSN - 0001-6349
DOI - 10.1111/j.1600-0412.2011.01105.x
Subject(s) - medicine , breech presentation , obstetrics , external cephalic version , odds ratio , vaginal delivery , cephalic presentation , gynecology , pregnancy , genetics , pathology , biology
Abstract Fetal malpresentation, including persistent occipitoposterior position, is a major cause of dystocia resulting in obstetric interventions. We studied malpresentation among 11 957 consecutive singleton deliveries from 1995 to 2004. There were 1 030 deliveries with a malpresentation (8.6%). Cephalic malpresentations occurred in 5.4% of deliveries (persistent occipitoposterior 5.2%, face 0.1%, brow 0.14%), and 3.1% had breech presentation and 0.12% a transverse lie. The odds ratios (OR) for cesarean section were 14.89 (95%CI 11.91–18.63) in breech presentation and 4.57 (95% CI 3.85–5.42) in persistent occipitoposterior presentation. With persistent occipitoposterior position, the OR for instrumental vaginal delivery was 3.84 (95%CI 3.14–4.70). Primiparity was associated with increased malpresentation risks, as 54.6% of those with malpresentations were primiparous compared with 41.7% of those without (OR 1.68, 95%CI 1.48–1.91, p < 0.001). Primiparous women required more cesarean sections (OR 1.92, 95%CI 1.50–2.47) and instrumental deliveries (OR 2.89, 95%CI 1.50–2.47). Malpresentation frequently leads to cesarean section or instrumental delivery, especially among primiparous women.