Handling when the fetus is in the face

The article was consulted professionally by Specialist Doctor II Nguyen Thi Phuong Loan – Obstetrician and Gynecologist – Obstetrics and Gynecology Department – Share99 Hai Phong International Health Hub

The face is the head with the face of the fetus maximum face up. Although the abdominal examination found that the crown also has a vertical axis similar to the crown, the technique of birth support is much more difficult and complicated.

1. What is the fetus of the face?


The face will have four types: front left pelvic chin, rear left, right front and right rear

The face is the head with the maximum face of the fetus, which can appear from the beginning or as a consequence of the crown when the child does not bow well.

The fetus has a face that accounts for 0.2% of all types of stars during labor.

The marker used to determine the position and type of pregnancy when entering labor for the fetus is the fetal chin. Therefore, the largest diameter of the pregnancy when it reaches the birth is the lower chin diameter – the front one with an average length of 9.5cm. The face will determine on the back of the fetus, which side is on the opposite side. Accordingly, in terms of that type, the face will have four types: the left pelvic chin first, left, right first and right after. However, because the head has maximum back, the face has only one type of book is a protective chin style book.

2. Causes of fetal face

Causes of facial formation include factors that cause the head to back up or prevent the head from bowing well:

On the mother's side, the cause may be asymmetry between the head and pelvis when narrowing the upper waist or large fetus is the most important feature. In addition, it is also due to polyatherm, the mother has tumors in the pelvis such as uterine fibroids

On the fetal side, the fetus has a large neck, goiter, large chest, cranial malformations … accounts for the majority in cases of the face.

In addition, the pregnancy of the face is also caused by the appendix such as the umbilical cord wrapped around theneck, each other clinging low, multiple amniotic fluid …

Cervical fibroids

Uterine fibroids cause fetuses to face

3. Diagnosis of the fetus of the face

During pregnancy, the abdominal examination finds that the pregnancy of the face is similar to the crown with the uterus located along the longitudinal axis. The buttock pole is found at the base of the uterus. The lower pole is the head, solid, round and has two mounds of high, rounded occipital mounds and lower chin mounds, which are horseshoe-shaped. The back is partly palpated and will differ from the crown when it is still touching the deep groove between the back and head, which is the nape of the neck, also known as the "axe", sign. The fetal heart is heard in the opposite direction to the back, below the mother's navel.

During labor, if the amniotic head is still high, visiting the vagina will be difficult to touch the face. When the amniotic membrane has ruptured, the cervical enlarges, a palpable vaginal examination of the mouth, nose, cheekbones, arches will help determine the face.

4. Birth mechanism and how to handle the birth of a fetus

In the ovation, under the effect of contractionsof the uterus , the forehead begins to enter the frame, the head is more maximum to help the diameter lower the chin – the front ovation enters the diagonal diameter of the upper waist, reaching in a symmetrical fashion.

In the down and rotation, if the front chin type, under the effect of the anal lift muscle, the chin will be pushed towards the shore under the defense joint. After that, the fetal neck needs to pass the back of the protective joint for the shoulder to enter the frame to prepare for the head to bend gradually. Cons, if the rear chin type, the fetal neck must rotate more to help reach the shoulder.

In the window, chin and mouth of the fetus out to the mother's, the area under the chin will lean against the protective joint for the head of the notebook by bowing to the nose, eyes, forehead, occipital and finally the chin.

Because of the above characteristics, the first thing when supporting the face is to see if the pelvis is narrow. If in doubt, it is necessary to clear the pelvic size. Cesarean section will be in place if there is asymmetrical evidence of pelvic head.

In case the pelvis is normal, the front chin, the doctor or the householder needs to try to keep the amniotic membrane intact until the cervical membrane is fully open, waiting for natural birth. If labor lasts, it is possible to support childbirth with forceps. With the back chin position, the fetus can still give birth normally if it rotates itself into the front chin during labor. If the chin rotation fails and the fetus is alive, a cesarean section is required.

For modern medicine, classic procedures to cope with the birth of the face such as turning the face into a crown, using your hands or forceps to turn the back chin into the front chin, the procedure of rotating the pregnancy, pulling the pregnancy is no longer applied because it causes too much severe trauma and is dangerous for both mothers and children.

5. The ton of the birth of the face

The labor of the face is generally difficult and takes longer than the crown. The lower part of the uterus is established more slowly, the cervical also clears the opening slowly, and the amniotic fluid is prone to rupture earlier.

As for the mother, the software is prone to tearing because of the diameter of the large face. Early amniotic rupture increases the risk of infection afterwards.

Regarding the fetus, babies born with a face will have a face that is not as beautiful as with the crown due to edema, and the head of the skull will also be heavily deformed, especially long vertically. Besides, if labor is too long to cause the pregnancy to asphyxiate, it will cause a fairly bad reacceptation, the mortality rate is about 2.5 to 5% even if the fetus is full months.

In short, the face is an abnormal form of pregnancy, which makes birth support operation highly risky. Therefore, it is necessary to understand the principles of handling when having a fetus in the face so that the birth is convenient and safe for both mother and child.

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Source: emedicine.medscape; spinningbabies.com


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About: Minh Quynh

b1ffdb54307529964874ff53a5c5de33?s=90&d=identicon&r=gI am the author of Share99.net. I had been working in Vinmec International General Hospital for over 10 years. I dedicate my passion on every post in this site.


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