Face presentation.
The diagnosis, aetiology, management and outcome of face presentation were analyzed in 51 cases. Primigravidas accounted for 17.6%, multiparas for 54.9% and grand multiparas (5 deliveries or more) for 27.5%. Prematurity did not appear to be an important aetiologic factor. The position was mentum anterior in 26 patients (51%), all but one of whom were delivered vaginally. Of 12 fetuses in the mentum transverse position, 11 were delivered vaginally after spontaneous rotation to mentum anterior. Ten patients presented with mentum posterior; only 2 were delivered vaginally after spontaneous rotation. Three fetuses were diagnosed as face presentation during Caesarean section. The mean birth-weight of the infants who rotated from mentum posterior to mentum anterior was 3,425 +/- 35g, while that of those with persistent mentum posterior was 3,792 +/- 347 (p less than 0.01). Records of monitored fetal heart rate were available in 21 cases. Late decelerations and variable decelerations were recorded in 6 (28.5%). The incidence of Caesarean section was 25.5% compared to an overall incidence of 4.4% during the period of the study. Oxytocin was administered to 10 patients, and 7 of them were delivered vaginally. Early diagnosis of presentation and position, with close fetal surveillance may improve fetal outcome. In case of mento-posterior position, primary Caesarean section at term should be considered.
Schwartz
Z
Z
Dgani
R
R
Lancet
M
M
Kessler
I
I
D000328:Adult; D001724:Birth Weight; D036861:Delivery, Obstetric / Q000379:methods; D005145:Face; D005260:Female; D005313:Fetal Death / Q000209:etiology; D006340:Heart Rate, Fetal; D006801:Humans; D007226:Infant Mortality; D007231:Infant, Newborn; D007746:Labor Presentation; D008423:Maternal Age; D007744:Obstetric Labor Complications / Q000175:diagnosis; D010298:Parity; D011247:Pregnancy; D018566:Pregnancy, High-Risk; D012189:Retrospective Studies