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Concept
Presentation (obstetrics)
Summary
In obstetrics, the presentation of a fetus about to be born specifies which anatomical part of the fetus is leading, that is, is closest to the pelvic inlet of the birth canal. According to the leading part, this is identified as a cephalic, breech, or shoulder presentation. A malpresentation is any presentation other than a vertex presentation (with the top of the head first).
Thus the various presentations are:
cephalic presentation (head first):
vertex (crown)—the most common and associated with the fewest complications
sinciput (forehead)
brow (eyebrows)
face
chin
breech presentation (buttocks or feet first):
complete breech
footling breech
frank breech
shoulder presentation:
arm
shoulder
trunk
compound presentation—when any other part presents along with the fetal head
Definition: Relationship of fetal head to spine:
flexed, (this is the normal situation)
neutral ("military"),
extended.
hyperextended
Relationship of presenting part to maternal pelvis based on presentation. The fetus enters the pelvis in the occipito-transverse plane (left or right), descent, and flexion and then rotates 90 degrees to the occipitoanterior (most commonly).
Cephalic presentation
Vertex presentation with longitudinal lie:
Left occipitoanterior (LOA)—the occiput is close to the vagina (hence known as vertex presentation), facing anteriorly (forward with mother standing) and toward the left. This is the most common position and lie.
Right occipitoanterior (ROA)—the occiput faces anteriorly and toward the right. Less common than LOA, but not associated with labor complications.
Left occipitoposterior (LOP)—the occiput faces posteriorly (behind) and toward the left.
Right occipitoposterior (ROP)—the occiput faces posteriorly and toward the right.
Occipitoanterior—the occiput faces anteriorly (absolutely straight without any turning to any of the sides)
Occipitoposterior—the occiput faces posteriorly (absolutely straight without any turning to any of the sides)
Face presentation
Mentum anterior—the fetal chin is in the direction of the maternal pubic symphysis.
Official source
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