Brow presentation
- 2. Brow PresentationDefinitionIt is a cephalic presentation in which the head is midway between flexion and extension.IncidenceAbout 1:1000 labour.www.freelivedoctor.com
- 3. DiagnosisDuring pregnancy: It is difficult.The occiput and sinciput may be felt at the same level.Ultrasonography and X-ray may be helpful.www.freelivedoctor.com
- 4. DiagnosisDuring labour:In addition to the previous findings, vaginal examination reveals the following features:> frontal bones,> supra-orbital ridges, and>root of the nose but not the chin.www.freelivedoctor.com
- 5. Mechanism of Labour* Persistent brow: The engagement diameter is the mento-vertical 13.5 cm which is longer than any diameter of the inlet so there is no mechanism of labour and labour is obstructed.* Transient brow: may occur during conversion of vertex into face presentation. So if brow is flexed to become vertex or extended to become face it may be delivered.www.freelivedoctor.com
- 6. Management* Early in the first stage:> Exclude contracted pelvis, if present do caesarean section.> The case is considered as transient brow, observed carefully and given a chance for spontaneous conversion into either face or vertex.>The rest of management as other malpresentation.www.freelivedoctor.com
- 7. Management * Early in the first stage:> Exclude contracted pelvis, if present do caesarean section. >The case is considered as transient brow, observed carefully and given a chance for spontaneous conversion into either face or vertex. > The rest of management as other malpresentation.www.freelivedoctor.com
- 8. ManagementIn the second stage: The case is considered as persistent brow so:> Caesarean section is done if the foetus is living.> Craniotomy if the foetus is dead.www.freelivedoctor.com