Abstract
Purpose
To estimate the maternal and fetal prognosis for attempted vaginal deliveries of fetuses in face compared with vertex presentations. To evaluate the factors associated with a cesarean during labor for fetuses in face presentation.
Methods
This case–control study collected all the cases of face presentation in a university hospital level-3 maternity ward between 22 and 42 weeks of gestation over a 16-year period. For each case, we selected three control cases with vertex presentations delivered the same day. Cesareans before labor were excluded.
Results
We compared 60 attempted vaginal deliveries of fetuses in face presentation with 174 of fetuses in vertex presentation. The cesarean rate during labor was more than three times higher for the face presentations (31.7 vs 9.2%, P < 0.0001). Arterial pH values and Apgar scores were similar in both sets of newborns. After logistic regression, the factors associated with a cesarean during labor were nulliparity and early diagnosis of the presentation (i.e., before 5 cm dilatation). The initial position (mentum-anterior vs. transverse or posterior) was not significantly associated with the mode of delivery.
Conclusions
In face presentations, attempted vaginal delivery triples the cesarean risk. Nonetheless, more than two-thirds of these women give birth vaginally without any impairment of neonatal condition.
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References
Cunningham FG, Williams JW (2010) Williams obstetrics, 23rd edn. McGraw-Hill Medical, New York
Cruikshank DP, Cruikshank JE (1981) Face and brow presentation: a review. Clin Obstet Gynecol 24(2):333–351
Seeds JW, Cefalo RC (1982) Malpresentations. Clin Obstet Gynecol 25(1):145–156
Posner AC, Cohn S (1951) An analysis of 45 face presentations. Am J Obstet Gynecol 62(3):592–599
Reinke T (1953) Face presentation: a review of 94 cases. Am J Obstet Gynecol 66(6):1185–1190
Duff P (1981) Diagnosis and management of face presentation. Obstet Gynecol 57(1):105–112
Posner AC, Buch IM (1943) Face and persistent brow presentations. Surgery, Gynecology and Obstetrics 77:618–630
Sharmila V, Babu TA (2014) Unusual birth trauma involving face: a completely preventable iatrogenic injury. J Clin Neonatol 3(2):120–121
Chaoui A (1982) La présentation de la face. Facteurs de risques; déductions thérapeutiques. J Gynecol Obstet Biol Reprod 11:731–738
Benedetti TJ, Lowensohn RI, Truscott AM (1980) Face presentation at term. Obstet Gynecol 55(2):199–202
Bhal PS, Davies NJ, Chung T (1998) A population study of face and brow presentation. J Obstet Gynaecol 18(3):231–235
Shaffer BL, Cheng YW, Vargas JE, Laros RK, Caughey AB (2006) Face presentation: predictors and delivery route. Am J Obstet Gynecol. 194(5):e10–e12
Ducarme G, Ceccaldi P-F, Chesnoy V, Robinet G, Gabriel R (2006) Face presentation: retrospective study of 32 cases at term. Gynecol Obstet Fertil 34(5):393–396
Zayed F, Amarin Z, Obeidat B, Obeidat N, Alchalabi H, Lataifeh I (2008) Face and brow presentation in northern Jordan, over a decade of experience. Arch Gynecol Obstet 278(5):427–430
Schwartz Z, Dgani R, Lancet M, Kessler I (1986) Face presentation. Aust N Z J Obstet Gynaecol 26(3):172–176
Arsene E, Langlois C, Garabedian C, Clouqueur E, Deruelle P, Subtil D (2016) Prenatal factors related to face presentation: a case control study. Arch Gynecol Obstet 294(2):279–284
Audra P, Jacquot F (1988) Deflected cephalic presentation. A propos of 80 cases. Rev Fr Gynecol Obstet 83(5):355–357
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EA: project development, data collection, data analysis, and manuscript writing. CL: data analysis. EC: manuscript editing. PD: manuscript editing. DS: project development, data analysis, and manuscript writing/editing.
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Arsène, E., Langlois, C., Clouqueur, E. et al. Prognosis for deliveries in face presentation: a case–control study. Arch Gynecol Obstet 300, 869–874 (2019). https://doi.org/10.1007/s00404-019-05241-6
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DOI: https://doi.org/10.1007/s00404-019-05241-6