Aim

To determine factors associated with face presentation of term fetuses delivered.



Methods

Of 34 480 consecutive, term deliveries of uncomplicated pregnancies within a 3-year period, all live, singleton term fetuses with cephalic presentation in which no lethal anomalies occurred that were diagnosed with a face presentation were studied. Factors that may have contributed to the etiology of the presentation including age, parity and fetal size were evaluated. Ultrasonographic evaluation was recorded.



Results

Fifty cases were diagnosed with an incidence of 0.14%. Parity was not associated with face presentation. Birthweight of 4000 g or more indicated an increased risk of approximately 2.9-fold, whereas fetuses weighing 3000–3499 g were found to have a relatively decreased risk of face presentation when compared with the general obstetrics group (P = 0.015 and 0.001, risk ratio = 2.948 and 0.450, respectively). With physical examination, only 70% were diagnosed correctly.



Conclusion

Face presentation is a rare event and birthweight more than 4000 g was found to be associated with face presentation. Parity is not an associated factor.

Face presentation at term: a forgotten issue.

Face presentation is a rare obstetric event and most practitioners will go through their carriers without ever meeting one. Face presentation can be delivered vaginally only if the foetus is in the mentum anterior position. More than half of the cases of face presentation are delivered by caesarean section. Newborn infants with face presentation usually have severe facial oedema, facial bruising or ecchymosis. These syndromic facial features usually resolved within 24-48 hours.

Johnson Ce

Papers

Abnormal fetal presentations.