All presentations of the foetus other than vertex

Aetiology

Predisposing factors to malpresentation include:

• Prematurity
• Multiple pregnancy
• Abnormalities of the uterus - e.g. fibroids
• Partial septate uterus
• Abnormal fetus
• Placenta praevia
• Primiparity

Breech presentation

• Breech presentation is the most common malpresentation
• Occurs when the the foetus presents 'bottom-down' in the uterus

Management

• All women in the UK with an uncomplicated breech pregnancy at term should be offered external cephalic version (ECV), provided there are no contra-indications
• The main decision is whether to attempt vaginal delivery or plan an elective caesarean section

Transverse lie

• Foetus is positioned with the head on one side of the pelvis and the buttocks in the other