The Brow presentation or Face presentation is a type of baby’s position in which during the labor; the baby’s head will try to get out of the birth canal through a deflexed position; to understand simply the baby’s head is tilted up.

In broader terms; a deflexed position is a term used to describe the baby’s position in which the neck and the head are extended; looking up.

It is a serious condition; because it can cause problems to the childbearing; and it can possibly cause injury to the baby; the ideal position of the baby’s head should be in a flexed position meaning that the baby’s chin should be pleated in the chest downwards; in this way the baby’s head tilted downwards will easily fit through the woman’s pelvis.

The occurrence of face presentation

Brow presentation is a rare occurrence; although brow presentation can occur at any time given the pregnancy period; the baby’s head always goes with the flexed position.

There are some instances in which the midwife will detect that baby’s position is reflexed during the week 34 and comes out normal with no risk or complications; the deflexed head and neck of the baby could change over time; although it is advisable to consult the midwife; or doctor to check the lateral position of the baby; and to determine if you will have an easy labor or not.

Brow presentation is also said to less likely occur in first child; and if you have a child with head first or brow; the first position it doesn’t mean that your next baby would have one; it is just a matter of occurring chances.

Possible causes of face presentation 

There can be a variety of causes that can make the baby’s position deflexed; brow and face presentation can often happen due to the size of the woman’s pelvis; or any uterine shape abnormalities; brow presentation could also mean the baby will be premature; or has abnormalities that prevent the baby from tucking his or her chin.

It could also be because of polyhydramnios a condition that causes high levels of amniotic fluid that could affect the way the baby presents itself during the labor.

There are also some instances that the cord may entangle the baby’s neck which could result in brow presentation; although these causes are relatively worrying to the mother; it can be solved; and assessed properly by a licensed doctor or midwife.

Risk and complications

If the baby’s head position doesn’t change and retains the brow or head presentation; it could possibly mean that the baby is at risk of genetic abnormalities or may be born prematurely.

In addition to this, if the baby’s position doesn’t progress especially if the baby’s chin is close to your tailbone instead of your pubic bone where vaginal labor commonly occurs and flows into; the doctor or midwife may prescribe a caesarian section.

During the labor; the baby can change its head position going from deflexed to flexed making it an optimal position for vaginal delivery; however; this is not the case the doctors may use different surgical instruments and machines to help correct the baby’s head and neck position.

Depending on the expertise of your doctor to the laboring process; there are still ways to fix the baby’s position to avoid undergoing through cesarean section although; it will usually involve the mother’s consent for ethical considerations; as every outcome might be difficult to change and revert back once it is done.

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The informed consent of the mother is necessary during the baby delivery; informed consent usually involves the course of action that the doctors will do during the delivery; the risks and outcomes of a possible mode of action and to also discuss some alternative modes of delivery to the mother.

The doctors will do every necessary course of action to make sure that the baby is going to be delivered safely; without any complications; as it is necessary for the head position to be properly corrected as it may pose risks to the baby during the labor; the baby’s deflexed position could result in traumatic head injuries during the labor; oxygen deprivation due to prolonged childbirth and other brain disorders such as seizure; and cerebral palsy that can be the effect of doctors failing to manage the brow presentation during and before the labor; it is necessary to manage this problem as early as possible to prevent further long-lasting effects that could harm the baby.

Early detection and prevention of brow presentation

Face-first or brow-first presentation is commonly detected during week 28 onwards through ultrasound imaging, or MRI scanning and it is usually the first assessment of the doctor whether the baby’s position is in a deflexed or flexed position.

It can also be diagnosed through abdominal palpitations by the doctor; nonetheless, brow presentation is usually confirmed by the assessment of dilated cervix.

There are also no known preventive measures that can be done by the doctor; or the mother itself; the best word that can be described in this condition is management; there are no known ways for it to be prevented nonetheless; it can still be managed by your midwife and doctor; if you are worried about the baby’s outcome it is best to seek the doctor’s advice for further help and assessment.

Final notes

Always remember; that pregnancy is crucial to the future development of the baby and if a condition poses a risk to your child; it is best to stick with the advice of the doctor and medical professionals in order to avoid complications in the long run.

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