Introduction
An understanding of fetal malpresentation, malposition, and cephalopelvic disproportion (CPD) is required by every obstetrician and midwife in order to provide safe and effective care in labour.
Deviations from normal of the fetal lie, presentation, or position may be apparent in the late antenatal period but in many cases the diagnosis only becomes apparent during the course of labour. A diagnosis of CPD may be suspected in advance of labour but can only be confirmed reliably as labour progresses. Recognition of the aetiological factors that contribute to these abnormalities provides an opportunity for risk assessment which may facilitate preventative strategies. Timely diagnosis is essential for appropriate intervention and overall management. Fetal malpresentation, malposition, and CPD are associated with increased maternal and fetal morbidity— this applies in well-resourced healthcare settings and to an even greater degree in low-resource settings.
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