A birth face, also known as face presentation, is a specific type of cephalic presentation during childbirth where the baby's head is severely extended, so the face, rather than the crown of the head, is presenting first in the birth canal.
Here's a more detailed breakdown:
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Cephalic Presentation: This refers to any birth presentation where the baby's head is the presenting part. It's the most common and generally safest position for delivery.
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Face Presentation (Birth Face): Within cephalic presentations, there are variations. In face presentation, the baby's neck is extremely arched backwards (hyperextended). Consequently, the baby's face, from the forehead to the chin, is the leading part during labor.
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Why it Happens: Several factors can contribute to face presentation, including:
- Multiple pregnancies: Women who have had several pregnancies may have weaker abdominal muscles, which can contribute to abnormal positioning.
- Pelvic abnormalities: Unusual pelvic shapes can impede the descent of the baby in a normal position.
- Fetal abnormalities: Some fetal anomalies, such as anencephaly (a severe neural tube defect), can affect fetal positioning.
- Polyhydramnios: Excessive amniotic fluid may allow the fetus more room to move and assume an unusual position.
- Prematurity: Premature babies are more likely to be in malpresentations.
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Diagnosis: Face presentation is usually diagnosed during labor through vaginal examination. The fetal facial features can be felt. Ultrasound can confirm the diagnosis.
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Management: The management of face presentation depends on several factors, including the baby's position (mentum anterior or mentum posterior) and the progress of labor.
- Mentum Anterior: If the baby's chin (mentum) is facing the mother's front (anterior), vaginal delivery may be possible, though labor might be longer and more complicated.
- Mentum Posterior: If the baby's chin is facing the mother's back (posterior), vaginal delivery is often impossible, and a Cesarean section is usually required.
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Risks: Face presentation can increase the risk of:
- Prolonged labor: Labor may take longer because the baby's head is not optimally positioned to dilate the cervix.
- Fetal distress: The baby may experience distress due to the pressure on the head and umbilical cord.
- Birth trauma: There's an increased risk of injury to the baby, such as facial bruising or swelling.
- Cesarean delivery: A C-section might be necessary if labor isn't progressing or if there are signs of fetal distress.
In summary, a birth face (face presentation) is a malpresentation during childbirth where the baby's face emerges first due to extreme hyperextension of the neck. The management and potential outcomes depend on the baby's position and the progress of labor.