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Prognosis for deliveries in face presentation: a case-control study.

Emmanuelle Arsène1, C Langlois2, E Clouqueur3

  • 1Pôle Femme Mère Enfant, Centre Hospitalier de Calais, Boulevard des Justes, 62100, Calais, France. emmanuelle.arsene@hotmail.fr.

Archives of Gynecology and Obstetrics
|July 15, 2019
PubMed
Summary
This summary is machine-generated.

Attempting vaginal delivery for face presentations triples cesarean risk. However, most women deliver vaginally without impacting neonatal outcomes, indicating careful consideration is needed.

Keywords:
CesareanDeflexed presentationFace presentationPrognosis

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Area of Science:

  • Obstetrics and Gynecology
  • Maternal-Fetal Medicine
  • Perinatal Outcomes

Background:

  • Face presentation, a malpresentation during labor, poses unique challenges for vaginal delivery.
  • Understanding the risks and outcomes associated with face presentation is crucial for clinical decision-making.

Purpose of the Study:

  • To compare maternal and fetal prognosis for attempted vaginal deliveries in face versus vertex presentations.
  • To identify factors associated with cesarean delivery during labor for fetuses in face presentation.

Main Methods:

  • A 16-year case-control study was conducted in a university hospital's level-3 maternity ward.
  • 60 cases of face presentation were compared with 174 control cases of vertex presentation, excluding pre-labor cesareans.

Main Results:

  • The cesarean rate during labor was significantly higher for face presentations (31.7%) compared to vertex presentations (9.2%).
  • Nulliparity and early diagnosis of face presentation (before 5 cm dilatation) were associated with increased cesarean rates.
  • Neonatal outcomes, including arterial pH and Apgar scores, were similar between the groups.

Conclusions:

  • Attempted vaginal delivery in face presentations increases the risk of cesarean delivery threefold.
  • Despite the increased cesarean risk, over two-thirds of women with face presentations achieve vaginal birth without adverse neonatal effects.