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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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Related publications (3)
Related concepts (2)
Breech birth
A breech birth is when a baby is born bottom first instead of head first, as is normal. Around 3–5% of pregnant women at term (37–40 weeks pregnant) have a breech baby. Due to their higher than average rate of possible complications for the baby, breech births are generally considered higher risk. Breech births also occur in many other mammals such as dogs and horses, see veterinary obstetrics. Most babies in the breech position are delivered via caesarean section because it is seen as safer than being born vaginally.
Caesarean section
Caesarean section, also known as C-section or caesarean delivery, is the surgical procedure by which one or more babies are delivered through an incision in the mother's abdomen, often performed because vaginal delivery would put the baby or mother at risk. Reasons for the operation include obstructed labor, twin pregnancy, high blood pressure in the mother, breech birth, shoulder presentation, and problems with the placenta or umbilical cord. A caesarean delivery may be performed based upon the shape of the mother's pelvis or history of a previous C-section.