II. Definitions

  1. Brow Presentation
    1. Head hyperextended, with brow as presenting part

III. Pathophysiology

  1. Normal Attitude: Fetus is in full flexion
    1. Smallest fetal head diameter: Suboccipitobregmatic
  2. Brow 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

IV. Epidemiology

  1. Incidence: 0.02% of singleton deliveries (1 in 1400 live births)

V. Causes

  1. Similar to Face Presentation

VI. Signs

  1. Digital cervical exam
    1. Forehead features palpable (anterior Fontanel, nose)

VII. Management

  1. Ceserean section required in most cases
  2. Brow Presentation rarely can deliver vaginally unless:
    1. Spontaneously converts to vertex or Face Presentation
    2. Fetus is very small or Pelvis is very large
  3. Do not attempt to convert Brow Presentation to vertex
  4. Never apply vacuum extractor to Brow Presentation
  5. Do not apply internal scalp electrodes
  6. Avoid Oxytocin

VIII. Complications

  1. Increased perinatal mortality: 1-8%

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Related Studies

Ontology: Brow presentation (C0233276)

Definition (NCI) A fetal presentation during delivery in which the brow of the fetus is first to descend into the birth canal.(NICHD)
Concepts Finding (T033)
SnomedCT 267210006, 199372005, 267327001, 156159007, 8014007
English Brow presentation NOS, brow presentation of fetus (diagnosis), brow presentation of fetus, brow presentation, brow presentation (physical finding), Brow presentation of fetus, Brow presentation NOS (finding), Brow Presentation, Brow presentation of foetus, Brow presentation, Brow presentation (finding), brow; presentation, presentation; brow
Italian Presentazione frontale, Presentazione frontale del feto
Dutch voorhoofdsligging van foetus, voorhoofdsligging foetus, ligging; voorhoofd, voorhoofd; ligging, voorhoofdsligging
French Présentation du foetus par le front, Présentation du front
German Stirnlage des Feten, Stirnlage
Portuguese Apresentação do feto de fronte, Apresentação de fronte do feto, Apresentação do supercílio
Spanish Presentación fetal de cara, Presentación fetal de frente, presentación de frente, SAI, presentación de bregma, SAI, presentación de bregma, SAI (hallazgo), presentación cefálica de bregma (hallazgo), presentación cefálica de bregma, Presentación de frente, presentación de frente, SAI (hallazgo)
Japanese 胎児額位, 額位, タイジガクイ, ガクイ
Czech Čelní poloha plodu, Čelní poloha
Hungarian Magzat homloktartása, Foetus homloktartása, Homloktartás