Managing Complications in Pregnancy and Childbirth: - IAWG

Malpositions and malpresentationsS-79FACE PRESENTATIONThe chin serves as the reference point in describing the position of thehead. It is necessary to distinguish only chin-anterior positions inwhich the chin is anterior in relation to the maternal pelvis (Fig S-24 A) from chin-posterior positions (Fig S-24 B).FIGURE S-24Face presentationProlonged labour is common. Descent and delivery of the head byflexion may occur in the chin-anterior position. In the chin-posteriorposition, however, the fully extended head is blocked by the sacrum.This prevents descent and labour is arrested.CHIN-ANTERIOR POSITION• If the cervix is fully dilated:- Allow to proceed with normal childbirth (page C-71);- If there is slow progress and no sign of obstruction (Table S-10, page S-57), augment labour with oxytocin (page P-25);- If descent is unsatisfactory, deliver by forceps (page P-33).• If the cervix is not fully dilated and there are no signs ofobstruction, augment labour with oxytocin (page P-25). Reviewprogress as with vertex presentation.