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Face Presentation
- Pathophysiology
- Normal Attitude: Fetus is in full flexion
- Smallest fetal head diameter: Suboccipitobregmatic
- Face presentation is an extended attitude
- Results in largest head diameter: Occipitomental
- Increases diameter 3 cm (24%) over flexed head
- May results in Failure to Progress
- Normal Attitude: Fetus is in full flexion
- Epidemiology
- Incidence: 0.1 to 0.2% of singleton deliveries
- Definition
- Head hyperextended, with face as presenting part
- Causes
- Grand multiparous patients
- Large fetus and contracted pelvis
- Neck swelling (e.g. Cystic Hygroma, Thyroid Goiter)
- Anencephaly
- Signs
- Digital cervical exam
- Facial features palpable (mouth, nose)
- Digital cervical exam
- Differential Diagnosis
- Breech Presentation (much more common than face)
- Management
- Do not attempt to convert face presentation to vertex
- Never apply vacuum extractor to face presentation
- Do not apply internal scalp electrodes
- Avoid Oxytocin in most cases
- Consider large episiotomy if fetus delivers vaginally
Face presentation NOS (C0233269) | |
|---|---|
| Concepts | Finding (T033) |
| English | Face presentation |
| Spanish | presentacion de cara |
| Parent Concepts | Fetal Malpresentation (C0233256), Face presentation NOS (C0233269) |
| Sources | SCTSPA, SNOMEDCT Derived from the NIH UMLS (Unified Medical Language System) |
