Face and brow presentation: Independent risk factors

Bashiri, Asher; Burstein, Eliezer; Bar-David, Juri; Levy, Amalia; Mazor, Moshe

doi:10.1080/14767050802037647

Cited by 22 publications

(16 citation statements)

References 15 publications

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“…Reported perinatal mortality, corrected for non‐viable malformations and extreme prematurity, varies from 0.6% to 5%, and cesarean delivery has been reported in up to 67.1% of cases of face presentation . Except for mentum posterior cases, safe vaginal delivery is suggested to be accomplished, and a trial of labor with careful monitoring of fetal condition and progress is not contraindicated unless macrosomia or a small pelvis is identified.…”

Section: Discussionmentioning

confidence: 99%

Face presentation at term: A forgotten issue

Tapisiz

Aytan

Altınbaş

et al. 2014

J of Obstet and Gynaecol

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Section: Discussionmentioning

confidence: 99%

Face presentation at term: A forgotten issue

Tapisiz

Aytan

Altınbaş

et al. 2014

J of Obstet and Gynaecol

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“…Additional complications include premature rupture of membranes, pre PROM, placental abruption, cesarean delivery, postpartum hemorrhage, fetal malpresentations and significant perinatal mortality. 7,8,9,10,11 A study revealed significantly higher incidence of birth weight >4000 gm in mild unexplained polyhydramnios group as compared to the explained polyhydramnios group (18.6% vs 8.6%) with (p value <0.05 which is statistically significant). 12 Another study documented that the idiopathic polyhydramnios was not associated with an increased incidence of established perinatal outcomes like preterm births, small for gestational age, low birth weight, low APGAR score after 5 minutes of neonatal life, admissions of babies into NICUs and perinatal deaths.…”

Section: Introductionmentioning

confidence: 94%

Polyhydramnios

Zulfiqar

Khan²,

Shakeel

et al. 2018

TPMJ

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Background: Polyhydramnios is a condition characterized by excessiveamniotic fluid around the baby. The most widespread causes of severe Polyhydramnios are fetalanomalies often linked with a primary genetic anomaly. However, gestational diabetes, multiplepregnancies and idiopathic factors are commonly related with milder cases. So, we designedthis study to see the association of polyhydramnios and perinatal outcome. Objectives: Tocompare the Perinatal outcomes in patients with explained and unexplained Polyhydramnios.Study Design: Cohort study. Setting: Obstetrics & Gynaecology Department and Diabetesclinic of Postgraduate Medical Institute, Lahore General Hospital. Period: 6 months From Jan2014 to June 2014. Material & Methods: 300 females were included through Non probabilitypurposive sampling. Informed consent and Demographic history was recorded. The patientswere divided into two groups. Those having congenital anomalies and diabetes mellitusdetermined by ultrasonography and laboratory investigations were included in Group ‘I’ andpatients with no detectable cause of polyhydramnios were included in Group ‘II’. All the data wasrecorded in well-defined proforma. Data was entered and analyzed through SPSS 20. Relativerisk was calculated to see any association between perinatal outcomes in both study groups.RR > 1 was considered as statistically significant. Results: The mean age of the patients wasnoted as 29.37±5.37 years. The mean gestational age was noted as 34.82±2.09 weeks. In thisstudy, Macrosomia was observed in 60 (20%) cases whereas Malpresentation was observedin 51 (17%) cases. Malpresentation was observed in 51 patients out of which 14 (27.5%) werefrom explained Polyhydramnios and 37 (72.5%) were from unexplained Polyhydramnios group.Statistically there is significant difference between the study groups i.e. RR=3.181. Macrosomiawas observed in 60 patients out of which 18 (30%) were from explained Polyhydramnios groupand 42 (70%) were from unexplained Polyhydramnios group. Statistically there is significantdifference between the study groups i.e. RR=2.852. Conclusion: It was concluded throughresults of this study that unexplained Polyhydramnios has more risk of developing adverseperinatal outcome.

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“…The frequency of deflexion is likely to be lower when the progression is normal. However, although brow and sinciput presentations are commonly reported to be rare events [13][14][15] , the true incidence may be underestimated. The digital examination has already been proven inaccurate for diagnosing fetal position [7,8,10,34,35] , and we expect it to be equally imprecise in assessing fetal attitude.…”

Section: Strength and Limitationsmentioning

confidence: 99%

“…In the remaining 3 cases, the orbits oriented upward in a transverse view of the maternal abdomen as the hallmark of OP presentation [2,[4][5][6][7][8][9][10] , a variety of the vertex presentation that may obstruct labor but is compatible with spontaneous vaginal delivery in a substantial proportion of cases [11,12] . OP rotation may also occur with deflexed presentations, such as sinciput and brow, that are known to interfere to a greater extent with the descent of the fetal head [13][14][15] .…”

Section: Introductionmentioning

confidence: 99%

Intrapartum Ultrasound to Differentiate Flexion and Deflexion in Occipitoposterior Rotation

et al. 2017

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Objective: To evaluate the ability of intrapartum ultrasound to differentiate occipitoposterior (OP) rotation with normal flexion of the head from deflexion, to compare the accuracy of ultrasound with the digital examination, and to assess the outcome of labor according to the type of presentation. Patients and Methods: A retrospective study of patients with abnormal labor because of either prolongation and/or abnormal cardiotocography and OP rotation who underwent intrapartum sonography. Results: Normal flexion was inferred in 36/42 cases by a longitudinal sonographic view of the fetal face demonstrating the chin approaching the chest. In the remaining 6, deflexion was diagnosed by visualizing the chin separate and distant from the chest. In 3 of these cases, the orbits were at the same level of the pubis suggesting brow presentation. In the remaining 3 cases, the orbits were above the pubis, and sinciput presentation was inferred. Head deflexion was diagnosed more accurately with ultrasound than clinically and always required a cesarean section versus 36% of cases with OP flexed presentation (p = 0.0052). Conclusions: Fetuses with abnormal labor and OP rotation had deflexed presentations in 14% of cases and were never delivered vaginally. Sonography was far more accurate than the digital examination.

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Face and brow presentation: Independent risk factors

Abstract: Face/brow presentation was associated with several adverse pregnancy outcomes, although there was a favorable neonatal outcome. Independent risk factors for face/brow presentation were fetal malformations and polyhydramnios, but primiparity had a protective effect.

Cited by 22 publications

References 15 publications

Face presentation at term: A forgotten issue

Face presentation at term: A forgotten issue

Polyhydramnios

Intrapartum Ultrasound to Differentiate Flexion and Deflexion in Occipitoposterior Rotation

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