Face presentation

Prepared by:
Dr. Gehanath Baral
MBBS,DGO,MD
Senior Consultant Gynecologist & Obstetrician: Government of
Nepal
Visiting Professor: CTGU
27th March,2007

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Abd. & P/V picture:

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 Cause
Maternal Fetal
1. Anencephaly
1. Multiparity 2. Congenital goitre
3. Branchial cyst
2. Contracted pelvis 4. Cord round the neck
5. Fetal dystonia
6. Increase AP
diameter of head

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 Mechanism of labor
1. Engagement Submentobregmatic

2. Int.rotation

3. Head delivery (in the order of-)

Chin Face Brow Vertex Occiput

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 Engagement
Submentobregmatic

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Dx steps:

Obstetric grips

USG

P/V exam

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 Dx: P/V exam
Face Breech
1. Mouth & Malar 1. Anus & Buttock make a
eminences make a straight line
triangle

2. Hard alveolar margin 2. Soft margin

3. Sucking effect 3. No sucking effect

4. No meconeum 4. Meconeum present

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 Risk 1

• Face not tightly fit to lower segment

1. PROM
2. Cord prolapse

• Delay in labor
1. No moulding of face
2. Delayed engagement and Int.rotation
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 Risk 2

• Perineal tear

• PPH

• Neonatal risk
1. Cerebral congestion,
2. Laryngeal edema,
3. Neonatal infection from vagina