Obstetrics Book

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Face Presentation

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  1. Pathophysiology
    1. Normal Attitude: Fetus is in full flexion
      1. Smallest fetal head diameter: Suboccipitobregmatic
    2. Face presentation is an extended attitude
      1. Results in largest head diameter: Occipitomental
      2. Increases diameter 3 cm (24%) over flexed head
      3. May results in Failure to Progress
  2. Epidemiology
    1. Incidence: 0.1 to 0.2% of singleton deliveries
  3. Definition
    1. Head hyperextended, with face as presenting part
  4. Causes
    1. Grand multiparous patients
    2. Large fetus and contracted pelvis
    3. Neck swelling (e.g. Cystic Hygroma, Thyroid Goiter)
    4. Anencephaly
  5. Signs
    1. Digital cervical exam
      1. Facial features palpable (mouth, nose)
  6. Differential Diagnosis
    1. Breech Presentation (much more common than face)
  7. Management
    1. Do not attempt to convert face presentation to vertex
    2. Never apply vacuum extractor to face presentation
    3. Do not apply internal scalp electrodes
    4. Avoid Oxytocin in most cases
    5. Consider large episiotomy if fetus delivers vaginally

Face presentation NOS (C0233269)

ConceptsFinding (T033)
EnglishFace presentation
Spanishpresentacion de cara
Parent ConceptsFetal Malpresentation (C0233256), Face presentation NOS (C0233269)
SourcesSCTSPA, SNOMEDCT
Derived from the NIH UMLS (Unified Medical Language System)



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