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WHAT DO YOU DO WHEN THE BABY IS WINKING AT YOU? CASE REPORT OF A FACE PRESENTATION

Authors

  • Mary K. Barger CNM, MPH

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    • Mary K. Barger is an Assistant Professor and Director of the Boston University School of Public Health Nurse-Midwifery Education Program. She received her nurse-midwifery education and master's of public health from the Johns Hopkins School of Hygiene and Public Health. She has been actively practicing and teaching nurse-midwifery for more than 20 years.


Boston University School of Public Health, T-5W, 715 Albany St, Boston, MA 02118.

ABSTRACT

Face presentation is an uncommon presentation at birth. The identification of a fetus with a hyperextended neck on ultrasound antenatally warrants close scrutiny for other anomalies. A fetus who presents as a face presentation in labor that is of average estimated fetal weight and has no anomalies in a woman with an adequate pelvis is likely to deliver vaginally if the mentum rotates to anterior prior to birth. Persistent mentum posteriors are best left alone without manual intervention and delivered by cesarean section. Prolonged labor is common. The clinician must be patient and closely monitor descent and rotation. Infants born as face presentations should be assessed closely after birth for normal respiratory transition and the presence of significant pain warranting analgesics.

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