Intrapartum ultrasound for the diagnosis of cephalic malpositions and malpresentations

Am J Obstet Gynecol MFM. 2021 Nov;3(6S):100438. doi: 10.1016/j.ajogmf.2021.100438. Epub 2021 Jul 22.

Abstract

Fetuses with malpresentation and malposition during labor represent important clinical challenges. Women with fetuses presenting with malpresentation or malposition are at risk of increased perinatal complications, such as cesarean delivery, failure of operative vaginal delivery, neonatal acidemia, and neonatal intensive care admission. Intrapartum ultrasound has been found to be more reliable than digital examination in assessing malpresentation and malposition. The use of intrapartum ultrasound to assess fetal position and presentation, in addition to fetal attitude, to predict and aid in decision making regarding delivery can help in improving management decision making. Cephalic malpresentation and malposition is a unique subset of fetal orientation and can benefit from intrapartum ultrasound identification and assessment for delivery.

Keywords: asynclitism; intrapartum sonography; intrapartum ultrasound; malposition; malpresentation.

Publication types

  • Review

MeSH terms

  • Delivery, Obstetric
  • Female
  • Fetus
  • Humans
  • Infant, Newborn
  • Labor Presentation*
  • Pregnancy
  • Ultrasonography
  • Ultrasonography, Prenatal*