Managing Complications in Pregnancy and Childbirth: - IAWG

S-74 Malpositions and malpresentationsTABLE S-12Diagnosis of malpresentationsSymptoms and SignsFigureBROW PRESENTATION is causedby partial extension of the fetal headso that the occiput is higher than thesinciput (Fig S-16).FIGURE S-16On abdominal examination, morethan half the fetal head is above thesymphysis pubis and the occiput ispalpable at a higher level than thesinciput.On vaginal examination, the anteriorfontanelle and the orbits are felt.For management, see page S-76.FACE PRESENTATION is causedby hyper-extension of the fetal headso that neither the occiput nor thesinciput are palpable on vaginalexamination (Fig S-17 and Fig S-18).FIGURE S-17On abdominal examination, agroove may be felt between theocciput and the back.On vaginal examination, the face ispalpated, the examiner’s finger entersthe mouth easily and the bony jawsare felt.FIGURE S-18For management, see page S-77.