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We believe that, although features such as preterm birth, LBW, SGA, operative delivery and malpresentation are not specific to PWS, their combined presence in the context of hypotonia and feeding difficulties should evoke PWS.
Of the 426 primary CS, 301 (70.6%) had a single indication; poor progression of labor being the most common 155 (51.5%), followed by fetal distress 83 (27.6%) and fetal malpresentation 36 (12.0%).
The significance of ANC is not surprising because it is contact time for identifying problems such as malpresentation and time to advise on sign of labor and timely arrival of laboring women to health facilities.
Self-Ratings of most important maternal reasons in decision making for CS delivery # Reason n % 1 Hypertensive disorders 34 60% 2 Abnormal labor pattern or arrest in progress of labor 31 54% 3 Previous cesarean section 19 33% 4 Cephalopelvic disproportion 19 33% 5 Maternal request 18 32% 6 Maternal complications 12 21% 7 Malpresentation of Fetus 12 21% 8 Diabetes mellitus 11 19% 9 Abnormal fetal well-being parameters 11 19% 10 Fetal macrosomia 6 11% Other causes 46 81% Missing 5 9% Total 57 100% Table 3.
These were followed by foetal distress 102(15.2%) non-progress of labour 93(13.9%) malpresentation 44(6.57%) placental abruption 21(3.13%) and placenta previa 19(2.84%).
These conditions are associated with spontaneous abortion (24%) in the first trimester, ectopic pregnancy (3%), fetal malpresentation (23%), high cesarean delivery rate (27.5%) and preterm delivery (29%) (1).
no complications 69% placenta praevia 4% malpresentation of the head 16% vertex presentation 1,40% bleeding 4,90% cracks of cervix and vagina 0,70% fetal head high straight bit 1,40% weakening of uterine contraction 1,40% preeclampsia 0,70% haematoma 0,70% Note: Table made from bar graph.
These women are also at greater risk of intrapartum complications related to macrosomia such as shoulder dystocia, malpresentation, haemorrhage and 4th degree perineal laceration.
Trauma or injury to the abdomen from an accident or fall, malpresentation of the baby and multiple pregnancies are some of the reasons for placental abruption," says Dr Madhu Roy, senior consultant gynaecologist, Indraprastha Apollo Hospital.
What if there is a malpresentation? What if the baby dies?
It usually presents with acute abdominal pain and hypovolaemic shock during labour, especially in the parturient with a scarred uterus owing to previous caesarean section or with malpresentation or second-stage dystocia (1,2).
Plagiocephaly may occur during pregnancy due to malpresentation of the fetus (10 or multiple births, (6) or after birth due to positional or environmental factors.