Brow presentation

Brow presentation refers to a specific position of the fetus during childbirth, where the brow, or forehead, is the leading part. This is a rare occurrence, happening in approximately 1 in 500 to 1 in 1400 deliveries. It is considered a type of malpresentation, as the normal and most common position for childbirth is the vertex presentation, where the top of the head leads the way.

Causes

The exact cause of brow presentation is not known, but it is associated with several factors. These include macrosomia (a larger-than-average baby), hydrocephalus (a condition where there is an accumulation of cerebrospinal fluid in the brain), and placenta previa (where the placenta covers the cervix). Other factors that may contribute to brow presentation include a long labour, an unusually shaped uterus, or a pelvis that is too small.

Diagnosis

Brow presentation can be diagnosed through a vaginal examination during labour. The healthcare provider may feel the prominent brow, eyes, or nose of the fetus. An ultrasound can also be used to confirm the diagnosis.

Management

The management of brow presentation depends on various factors, including the stage of labour, the size of the fetus, and the health of the mother. In some cases, a cesarean section may be necessary. If the labour is not too far advanced, it may be possible to manually change the position of the fetus to a more favourable one, such as vertex or face presentation. This is known as external cephalic version.

Complications

Brow presentation can lead to complications for both the mother and the baby. For the mother, these can include prolonged labour, increased risk of uterine rupture, and postpartum hemorrhage. For the baby, complications can include birth trauma, hypoxia (lack of oxygen), and neonatal death.

See also

• Vertex presentation
• Face presentation
• Breech presentation