II. Definitions
- Face Presentation
- Head hyperextended, with face as presenting part
III. Epidemiology
- Incidence: 0.1 to 0.2% of singleton deliveries (1 in 550 live births)
IV. Pathophysiology
- Normal Attitude: Fetus is in full flexion
- Smallest fetal head diameter: Suboccipitobregmatic
- Face Presentation is an extended attitude
- Full extension of fetal head with occiput against upper back
- Results in largest head diameter: Occipitomental
- Increases diameter 3 cm (24%) over flexed head
- May results in Failure to Progress
V. Causes
- Grand Multiparous patients
- Large fetus and contracted Pelvis
- Neck swelling (e.g. Cystic Hygroma, Thyroid Goiter)
- Anencephaly
VI. Signs
- Digital cervical exam
- Facial features palpable (mouth, nose)
VII. Differential Diagnosis
- Breech Presentation (much more common than face)
VIII. 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
IX. Associated Conditions
X. Complications
- Increased perinatal mortality: 2-3%
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Related Studies
| Definition (NCI) | A fetal presentation during delivery in which the face of the fetus is first to descend into the birth canal.(NICHD) |
| Concepts | Finding (T033) |
| SnomedCT | 267327001, 199368006, 156159007, 21882006 |
| English | Face presentation NOS, face presentation of fetus (diagnosis), face presentation of fetus, face presentation, face presentation (physical finding), Face Presentation, Face presentation NOS (finding), Face presentation, Face presentation (finding), presentation; face |
| Italian | Presentazione di faccia |
| Japanese | 顔位, ｶﾞﾝｲ |
| Czech | Obličejová poloha |
| Hungarian | Arctartás |
| Spanish | presentación de cara, SAI (hallazgo), presentación de cara, SAI, presentación de cara (hallazgo), presentación de cara, Presentación de cara |
| Dutch | ligging; aangezicht, aangezichtsligging |
| Portuguese | Apresentação de face |
| French | Présentation de la face |
| German | Gesichtslage |
