10.1. General considerations
Labor in malpresentation of the head and fetus includes delivery in deflexed cephalic presentation, asynclitic engagement of the head, delivery in high anteroposterior station of sagittal suture and deep transverse arrest, delivery in oblique and transverse lie of fetus. All these obstetric situations are considered pathological.
The causes of improper presentations of the head and malpresentations of the fetus include abnormality of the uterus shape (arcuate, bicornuate, septate uterus, leiomyoma, etc.), sagging of its lower segment, contracted pelvis, impaired fetal muscular tone.
Considering the sufficiently great maternal and fetal risk in the case of improper fetal lie and malpresentations, delivery is carried out by cesarean section. Currently, manual maneuvers for fetal malpresentations and changing of a presentation to more favorable one (fetal version, forced extension of the head) are not used due to a high rate of injuries and adverse outcomes.