Causes: Face presentation can occur due to factors such as abnormal fetal positioning, multiple pregnancies, uterine abnormalities, or maternal pelvic anatomy.Definition: Face presentation occurs when the baby's face is positioned to lead the way through the birth canal instead of the vertex (head).Cardinal Movements: The baby undergoes a series of cardinal movements, including flexion, internal rotation, extension, external rotation, and restitution, which facilitate the passage through the birth canal.Engagement and Descent: Prior to delivery, the baby's head engages in the pelvis and gradually descends, preparing for birth.Normal Vertex Presentation: In a typical delivery, the baby is positioned head-down, with the back of the head (occiput) leading the way through the birth canal.This comprehensive article aims to provide a thorough understanding of delivery, face presentation, and brow presentation, including their definitions, causes, complications, and management approaches. While the most common fetal presentation is the head-down position (vertex presentation), variations can occur, such as face presentation and brow presentation. Expulsion: After external rotation (restitution), the top shoulder is delivered under the mother’s pubic bone followed by the bottom shoulder, and then the rest of the baby’s body can be delivered with an upward movement by the healthcare professional.During childbirth, the position of the baby plays a significant role in the delivery process.This movement is also known as restitution. External Rotation/Restitution: Once the baby’s head is born, the baby must rotate from facing head down to either right or left to fit the shoulders around and under the mother’s pubic arch.The baby’s head, face, and chin appear outside the mother. The baby’s head must extend back to accommodate the upward curvature of the birth canal. Extension: Usually, the back of the baby’s head is against the mother’s pubic bone as it passes through the vaginal opening.Usually, the baby faces down toward the mother’s spine, although sometimes the baby faces the mother’s pubic bone. ![]() The baby’s head rotates to accommodate these changes in the diameter of the mother’s pelvis. Now, with the baby reaching the mother’s pelvic floor, the widest diameter of the mother’s pelvis is from front to back.
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