MALPRESENTATION INCIDENCE AND CAUSES

From one year hospital based data, incidence of malpresentation, their mode of delivery, fetal and maternal outcome was evaluated. A retrospective study was carried out in obstetric and gynecology unit "B" from 1" January 1999 to December 1999. From the hospital based obstetric record all malpresentationsʹ which were admitted in one year were identified and critically evaluated. There were 3002 deliveries during 1999. 286(9.52%) patients presented with malpresentation. Commonest malpresentation was breech (7.3%), followed by transverse lie (1.86%), brow (0.2%), and face presentation (0.09%). Majority of these occurred in mutigravidae 184 (64.3%). Pendulous and lax abdomen being the commonest cause. 210 (37.4%) delivered vaginally while 76 (26.5%) needed emergency operative management. 4 (1.39%) patients underwent subtotal abdominal hysterectomy as they presented with rupture uterus. Perinatal mortality was very high with all the malpresentation, being 153.8/1000 of total malpresentation. There was no maternal mortality. Incidence of all malpersentation in this study was very high then generally reported, because of unplanned reproductive pattern and lack of prenatal care and poor intrapartum care at periphery. Thus all patients being admitted to the tertiary level hospital in advanced labour, will all the sequel of obstructed labour. The general improvement of the overall socioeconomic condition is necessary to improve access to care.