The following are related to face presentation except:
Correct Answer: The diameter distending the vulval outlet is mentovertical
Description: Face presentation:
The attitude of the fetus shows complete flexion of the limbs with extension of the spine. There is complete extension of the head so that the occiput is in contact with the back.
The denominator is mentum.
The commonest position is left mentoanterior (LMA).
Face presentation present during pregnancy (primary) is rare, while that developing after the onset of labor (secondary) is common. It occurs more frequently seen in multiparae (70%), like other malpresentations.
Most common maternal cause is platypelloid pelvis and most common fetal cause is anencephaly.
The diameter of engagement is the oblique diameter—right in LMA, left in RMA.
The engaging diameter of the head is submento-bregmatic 9.5 cm (3 3/4”) in fully extended head or submentovertical 11.5 cm (4 1/2”) in partially extended head.
Engagement is delayed because of long distance between the mentum and biparietal plane (7 cm).
The head is born by flexion: (11.5 cm).
Vaginal delivery is possible in nentoanterior positions but not in persistent mentoposterior.
In mentoposterior during early stages of labor the policy of wait and watch should be adopted, in hope of mentoposterior getting converted to mentoanterior spontanelously. Persistent mentoposterior position is an indication for doing cesarean section.
Category:
Gynaecology & Obstetrics
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