Jemds.com Original Research Article J. Evolution Med. Dent. Sci./eISSN- 2278-4802, pISSN- 2278-4748/ Vol. 7/ Issue 02/ Jan. 08, 2018 Page 246 MALPRESENTATION- INCIDENCE AND CAUSES Anjali Srivastava 1 , Manjula Srivastava 2 , K. M. Preeti 3 1 Associate Professor, Department of Obstetrics and Gynaecology, Mahatma Gandhi Memorial Medical College and Hospital. 2 Assistant Professor, Department of Obstetrics and Gynaecology, Mahatma Gandhi Memorial Medical College and Hospital. 3 Junior Resident, Department of Obstetrics and Gynaecology, Mahatma Gandhi Memorial Medical College and Hospital. ABSTRACT BACKGROUND Malpresentation is defined as when the presenting part of foetus is other than normal vertex of foetal head. It includes breech, face, brow, shoulder, compound and cord presentations. In modern obstetrics, the incidence of malpresentation has fallen due to reducing parity. Among malpresentations, breech presentation is the most common. The aim of this study is to study the incidence, aetiological factors and foetomaternal outcome. MATERIALS AND METHODS A retrospective study of malpresentation was conducted in Obstetrics and Gynaecology Department for a period of 5 years from 1st January 2012 to 31 st December 2016 at MGMMCH, Jamshedpur, Jharkhand. The incidence, aetiological factors and foetomaternal outcome were discussed. RESULTS There were 28,431 deliveries conducted with 1099 malpresentations with an incidence of 3.87%. Out of these, 1099 (3.87%) patients presented with malpresentation. Commonest malpresentation was breech (2.85%) followed by transverse lie (0.60%), face presentation (0.23%), compound presentation (0.08%), cord presentation (0.07%) and brow presentation (0.04%). Most of these are unbooked cases, 692 (62.97%). In the present study, 45.38% occurred in primigravidae. Breech was the most common malpresentation, 334 (41.18%) cases were delivered by vaginal route. In the present study, 34 (3.09%) cases with malpresentations delivered anomalous babies. Prematurity was the aetiological factor accounting to 7.92% of the cases, 25.93% accounted to multiparity, 2.47% presented with uterine anomalies and 4.64% contracted pelvis, 3.10% presented with disorders of amniotic fluid volume and 1.09% cases had placenta previa and 6.39% accounting to twins. 15.37% babies were still birth associated with malpresentation and neonatal death was seen in 7.10%. The commonest cause of still birth is prematurity, transverse lie with hand prolapse. CONCLUSION Malpresentation requires high vigilance and prompt management to reduce perinatal mortality and maternal morbidity. KEYWORDS Malpresentations, Breech, Transverse Lie. HOW TO CITE THIS ARTICLE: Srivastava A, Srivastava M, Preeti KM. Malpresentation- incidence and causes. J. Evolution Med. Dent. Sci. 2018;7(02):246-248, DOI: 10.14260/jemds/2018/55 BACKGROUND Malpresentation is defined as when the presenting part of foetus is other than normal vertex of foetal head. It includes breech, face, brow, shoulder, compound and cord presentations. In vast majority of deliveries near term, the foetus presents by the head with the best fit into the lower pelvis. More than 95% of foetuses at term present in labour by the vertex. In modern obstetrics, the incidence of malpresentations has fallen due to reducing parity. Among malpresentations, breech presentation is the most common followed by transverse lie with shoulder presentation and face presentation, others like brow, compound and cord presentations are less common. Congenital anomalies and perinatal mortality are increased with malpresentations. ‘Financial or Other Competing Interest’: None. Submission 27-10-2017, Peer Review 20-12-2017, Acceptance 26-12-2017, Published 08-01-2018. Corresponding Author: Dr. Manjula Srivastava, Duplex-12, Vasundhara Estate, NH-33, Near Irrigation Colony, Dimna-831018, 1SR. E-mail: manjulasrivastava78@gmail.com DOI: 10.14260/jemds/2018/55 MATERIALS AND METHODS A retrospective study of malpresentation was conducted in Obstetrics and Gynaecology Department for a period of 5 years from 1st January 2012 to 31 st December 2016 at MGMMCH, Jamshedpur, Jharkhand. There were 28,431 deliveries conducted with 1099 malpresentations with an incidence of 3.87%. Different variables such as parity, booked-unbooked case, maternal risk factors, type of malpresentation, mode of delivery, foetal anomalies associated with malpresentation were analysed and reviewed to see its association with maternal and perinatal outcome. All history sheets, labour room records and operative record were scrutinised and relevant information was extracted. RESULTS Total numbers of deliveries conducted in Obstetrics and Gynaecology Department for a period of 5 years from 1st January 2012 to 31 st December 2016 at MGMMCH, Jamshedpur, Jharkhand were 28,431. Out of these 1099 (3.87%) patients presented with malpresentation. Breech presentation is the commonest 811 (73.79%), transverse lie with shoulder presentation are 170 (15.47%), face presentation are 64 (5.82%), compound presentations are 23