another term for face presentation

Fetal Presentation, Position, and Lie (Including Breech Presentation)

• Variations in Fetal Position and Presentation |

During pregnancy, the fetus can be positioned in many different ways inside the mother's uterus. The fetus may be head up or down or facing the mother's back or front. At first, the fetus can move around easily or shift position as the mother moves. Toward the end of the pregnancy the fetus is larger, has less room to move, and stays in one position. How the fetus is positioned has an important effect on delivery and, for certain positions, a cesarean delivery is necessary. There are medical terms that describe precisely how the fetus is positioned, and identifying the fetal position helps doctors to anticipate potential difficulties during labor and delivery.

Presentation refers to the part of the fetus’s body that leads the way out through the birth canal (called the presenting part). Usually, the head leads the way, but sometimes the buttocks (breech presentation), shoulder, or face leads the way.

Position refers to whether the fetus is facing backward (occiput anterior) or forward (occiput posterior). The occiput is a bone at the back of the baby's head. Therefore, facing backward is called occiput anterior (facing the mother’s back and facing down when the mother lies on her back). Facing forward is called occiput posterior (facing toward the mother's pubic bone and facing up when the mother lies on her back).

Lie refers to the angle of the fetus in relation to the mother and the uterus. Up-and-down (with the baby's spine parallel to mother's spine, called longitudinal) is normal, but sometimes the lie is sideways (transverse) or at an angle (oblique).

For these aspects of fetal positioning, the combination that is the most common, safest, and easiest for the mother to deliver is the following:

Head first (called vertex or cephalic presentation)

Facing backward (occiput anterior position)

Spine parallel to mother's spine (longitudinal lie)

Neck bent forward with chin tucked

Arms folded across the chest

If the fetus is in a different position, lie, or presentation, labor may be more difficult, and a normal vaginal delivery may not be possible.

Variations in fetal presentation, position, or lie may occur when

The fetus is too large for the mother's pelvis (fetopelvic disproportion).

The uterus is abnormally shaped or contains growths such as fibroids .

The fetus has a birth defect .

There is more than one fetus (multiple gestation).

Position and Presentation of the Fetus

Variations in Fetal Position and Presentation

Some variations in position and presentation that make delivery difficult occur frequently.

Occiput posterior position

In occiput posterior position (sometimes called sunny-side up), the fetus is head first (vertex presentation) but is facing forward (toward the mother's pubic bone—that is, facing up when the mother lies on her back). This is a very common position that is not abnormal, but it makes delivery more difficult than when the fetus is in the occiput anterior position (facing toward the mother's spine—that is facing down when the mother lies on her back).

When a fetus faces up, the neck is often straightened rather than bent,which requires more room for the head to pass through the birth canal. Delivery assisted by a vacuum device or forceps or cesarean delivery may be necessary.

Breech presentation

In breech presentation, the baby's buttocks or sometimes the feet are positioned to deliver first (before the head).

When delivered vaginally, babies that present buttocks first are more at risk of injury or even death than those that present head first.

The reason for the risks to babies in breech presentation is that the baby's hips and buttocks are not as wide as the head. Therefore, when the hips and buttocks pass through the cervix first, the passageway may not be wide enough for the head to pass through. In addition, when the head follows the buttocks, the neck may be bent slightly backwards. The neck being bent backward increases the width required for delivery as compared to when the head is angled forward with the chin tucked, which is the position that is easiest for delivery. Thus, the baby’s body may be delivered and then the head may get caught and not be able to pass through the birth canal. When the baby’s head is caught, this puts pressure on the umbilical cord in the birth canal, so that very little oxygen can reach the baby. Brain damage due to lack of oxygen is more common among breech babies than among those presenting head first.

In a first delivery, these problems may occur more frequently because a woman’s tissues have not been stretched by previous deliveries. Because of risk of injury or even death to the baby, cesarean delivery is preferred when the fetus is in breech presentation, unless the doctor is very experienced with and skilled at delivering breech babies or there is not an adequate facility or equipment to safely perform a cesarean delivery.

Breech presentation is more likely to occur in the following circumstances:

Labor starts too soon (preterm labor).

The uterus is abnormally shaped or contains abnormal growths such as fibroids .

Other presentations

In face presentation, the baby's neck arches back so that the face presents first rather than the top of the head.

In brow presentation, the neck is moderately arched so that the brow presents first.

Usually, fetuses do not stay in a face or brow presentation. These presentations often change to a vertex (top of the head) presentation before or during labor. If they do not, a cesarean delivery is usually recommended.

In transverse lie, the fetus lies horizontally across the birth canal and presents shoulder first. A cesarean delivery is done, unless the fetus is the second in a set of twins. In such a case, the fetus may be turned to be delivered through the vagina.

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Management of face presentation, face and lip edema in a primary healthcare facility case report, Mbengwi, Cameroon

Nzozone henry fomukong.

1 Microhealth Global Medical Centre, Mbengwi, Cameroon

2 Department of Medicine and Surgery, Faculty of Health Sciences University of Buea, Buea, Cameroon

Ngouagna Edwin

Mandeng ma linwa edgar, ngwayu claude nkfusai.

3 Department of Microbiology and Parasitology, Faculty of Science, University of Buea, Buea, Cameroon

4 Cameroon Baptist Convention Health Services (CBCHS), Yaoundé, Cameroon

Yunga Patience Ijang

5 Department of Public Health, School of Health Sciences, Catholic University of Central Africa, Box 1110, Yaoundé, Cameroon

Joyce Shirinde

6 School of Health Systems and Public Health, Faculty of Health Sciences, University of Pretoria Private Bag X323, Gezina, Pretoria, 0001, Pretoria, South Africa

Samuel Nambile Cumber

7 Institute of Medicine, Department of Public Health and Community Medicine (EPSO), University of Gothenburg, Box 414, SE - 405 30 Gothenburg, Sweden

8 Faculty of Health Sciences, University of the Free State, Bloemfontein, South Africa

Face presentation is a rare obstetric event and most practitioners will go through their carriers without ever meeting one. Face presentation can be delivered vaginally only if the foetus is in the mentum anterior position. More than half of the cases of face presentation are delivered by caesarean section. Newborn infants with face presentation usually have severe facial oedema, facial bruising or ecchymosis. These syndromic facial features usually resolved within 24-48 hours.

Introduction

Face presentation is a rare unanticipated obstetric event characterized by a longitudinal lie and full extension of the foetal head on the neck with the occiput against the upper back [ 1 - 3 ]. Face presentation occurs in 0.1-0.2% of deliveries [ 3 - 5 ] but is more common in black women and in multiparous women [ 5 ]. Studies have shown that 60 per cent of face presentations have one or more of the following risk factors: small fetus, large fetus, high parity, previous caesarean section (CS), contracted pelvis, fetopelvic disproportion, cord around the neck multiple pregnancy, hypertensive disorders of pregnancy, polyhydramnios, uterine or nuchal cord anomaly. But 40 per cent of face presentations occur with none of these factors [ 6 , 7 ]. A vaginal birth at term is possible only if the fetus is in the mentum anterior position. More than half of cases of face presentation are delivered by caesarean section [ 4 ]. Newborn infants with face presentation usually have severe facial edema, facial bruising or ecchymosis [ 8 ]. Repeated vaginal examination to assess the presenting part and the progress of labor may lead to bruises in the face as well as damage to the eyes.

Patient and observation

Case presentation: a 21 year old primigravida at 40 weeks gestation from the last normal menstrual period referred to our facility for prolonged second stage of labor after visiting two health centres. She labored for a total of 14hrs, membrane ruptured spontaneously 12hrs before referral. Amniotic fluid was documented by midwife to be clear. She attended antenatal clinics in Mbengwi health centre 5 times, was diagnosed of hepatitis B during antenatal consultations, received no treatment. She did not do any ultrasound due to financial constraints. On examination, she was healthy, in painful distress, blood pressure 131/76mmhg, pulse 85 beats/min, temperature 37.2 o C SPO2 98%. On abdominal exams, uterus was gravid, fundal height 35cm, lie longitudinal, fetal heart rate 137bpm, cephalic presentation, engaged 2/5, with moderate contractions of 2 in 10 minutes. On vaginal examination, cervix was fully dilated, membranes ruptured, presenting part was face, mentum anterior. The conclusion made was mento-anterior face presentation ( Figure 1 ). Paturient was counseled, labor was augmented with 1 amp of oxytocin in 500ml of glucose 5% and started at 10drops/mins. Ten minutes later she delivered a male baby with Apgar score 6/10, 8/10 on the first and fifth minute. The baby weighed 3.2kg, length was 50cm, and head circumference was 41cm. Syndromic facial appearance with marked edema at the baby's lips, face and scalp was evident and he had bruising on the right nasolabial groove and right cheeks ( Figure 2 ). Physical examination of the infant's respiratory system, cardiovascular system, and his abdominal examination were normal, as was his neurological examination. Placenta was delivered by controlled cord traction 5mins later with all cotyledons. Delivery was complicated by a second degree perineal tear. Perineal tear was repaired with absorbable suture under local anaesthesia. Estimated blood lost was 350ml. baby received Hepatitis B immunoglobulins, hepatitis B vaccine and vitamin K were administered to the baby. 24 hours later, facial swellings resolved ( Figure 3 ), baby breast feeds well. Baby and mother were discharged on day 3 postpartum all fine.

Men-tum anterior face presentation

Bruising, marked lip and facial edema

Baby 24 hours later with all syndromic facial features resolved

Ethics : informed consent: written informed consent was obtained from the patient's parents for the publication of this case report.

Face presentation is a rare obstetric event and most practitioner will go through their carriers without ever meeting one [ 3 ]. We presented a case of face presentation noticed in the delivery room on digital examination in a patient with no risk factors. In a poor resource setting as ours where ultrasound is not readily available, this event is often scary and confusing to most midwives and nurses. This may prompt repeated vaginal exams for confirmation of presentation. This intend will lead to bruising of the baby's face and delay effective management [ 8 ]. Exact knowledge about the fetal position and level is important for providing the correct management of this malpresentation. When face presentation is diagnosed, around 60% of cases are in the mentum anterior position, 25% are mentum posterior and 15% are mentum transverse [ 5 ]. The patient presented the most common form of face presentation (mentum anterior). Labor was augmented, vaginal delivery was attempted and successfully conducted. Facial bruising, lip and face edema are very common complication of face presentation. These complications usually resolve within 24-48 hours [ 9 , 10 ] in this case facial edema completely resolved within 24hours ( Figure 3 ) and baby breastfeed well.

Repeated vaginal exams should be avoided when presenting part is unsure. Vaginal delivery should be attemped only on mentum anterior face presentation, in other cases, emergency ceserian section should be performed. Syndromic facial features in babies born from face presentation resolve completely within 24-48 hours.

Competing interests

The authors declare no competing interests.

Acknowledgements

We thank the participant of this study.

Authors’ contributions

NHF, NE, MMLE, NCN, YPI, FB, JS and SNC conceived the case series, assisted with the study design and participant enrollment, designed the study protocol and collected the data. NE, MMLE, NCN and SNC assisted in interpretation of results and wrote the manuscript. All authors read and approved the final manuscript.

Face and Brow Presentation

• Author: Teresa Marino, MD; Chief Editor: Carl V Smith, MD  more...
• Sections Face and Brow Presentation
• Mechanism of Labor
• Labor Management

At the onset of labor, assessment of the fetal presentation with respect to the maternal birth canal is critical to the route of delivery. At term, the vast majority of fetuses present in the vertex presentation, where the fetal head is flexed so that the chin is in contact with the fetal thorax. The fetal spine typically lies along the longitudinal axis of the uterus. Nonvertex presentations (including breech, transverse lie, face, brow, and compound presentations) occur in less than 4% of fetuses at term. Malpresentation of the vertex presentation occurs if there is deflexion or extension of the fetal head leading to brow or face presentation, respectively.

In a face presentation, the fetal head and neck are hyperextended, causing the occiput to come in contact with the upper back of the fetus while lying in a longitudinal axis. The presenting portion of the fetus is the fetal face between the orbital ridges and the chin. The fetal chin (mentum) is the point designated for reference during an internal examination through the cervix. The occiput of a vertex is usually hard and has a smooth contour, while the face and brow tend to be more irregular and soft. Like the occiput, the mentum can present in any position relative to the maternal pelvis. For example, if the mentum presents in the left anterior quadrant of the maternal pelvis, it is designated as left mentum anterior (LMA).

In a brow presentation, the fetal head is midway between full flexion (vertex) and hyperextension (face) along a longitudinal axis. The presenting portion of the fetal head is between the orbital ridge and the anterior fontanel. The face and chin are not included. The frontal bones are the point of designation and can present (as with the occiput during a vertex delivery) in any position relative to the maternal pelvis. When the sagittal suture is transverse to the pelvic axis and the anterior fontanel is on the right maternal side, the fetus would be in the right frontotransverse position (RFT).

Face presentation occurs in 1 of every 600-800 live births, averaging about 0.2% of live births. Causative factors associated with a face presentation are similar to those leading to general malpresentation and those that prevent head flexion or favor extension. Possible etiology includes multiple gestations, grand multiparity, fetal malformations, prematurity, and cephalopelvic disproportion. At least one etiological factor may be identified in up to 90% of cases with face presentation.

Fetal anomalies such as hydrocephalus, anencephaly, and neck masses are common risk factors and may account for as many as 60% of cases of face presentation. For example, anencephaly is found in more than 30% of cases of face presentation. Fetal thyromegaly and neck masses also lead to extension of the fetal head.

A contracted pelvis or cephalopelvic disproportion, from either a small pelvis or a large fetus, occurs in 10-40% of cases. Multiparity or a large abdomen can cause decreased uterine tone, leading to natural extension of the fetal head.

Face presentation is diagnosed late in the first or second stage of labor by examination of a dilated cervix. On digital examination, the distinctive facial features of the nose, mouth, and chin, the malar bones, and particularly the orbital ridges can be palpated. This presentation can be confused with a breech presentation because the mouth may be confused with the anus and the malar bones or orbital ridges may be confused with the ischial tuberosities. The facial presentation has a triangular configuration of the mouth to the orbital ridges compared to the breech presentation of the anus and fetal genitalia. During Leopold maneuvers, diagnosis is very unlikely. Diagnosis can be confirmed by ultrasound evaluation, which reveals a hyperextended fetal neck. [ 1 , 2 ]

Brow presentation is the least common of all fetal presentations and the incidence varies from 1 in 500 deliveries to 1 in 1400 deliveries. Brow presentation may be encountered early in labor but is usually a transitional state and converts to a vertex presentation after the fetal neck flexes. Occasionally, further extension may occur resulting in a face presentation.

The causes of a persistent brow presentation are generally similar to those causing a face presentation and include cephalopelvic disproportion or pelvic contracture, increasing parity and prematurity. These are implicated in more than 60% of cases of persistent brow presentation. Premature rupture of membranes may precede brow presentation in as many as 27% of cases.

Diagnosis of a brow presentation can occasionally be made with abdominal palpation by Leopold maneuvers. A prominent occipital prominence is encountered along the fetal back, and the fetal chin is also palpable; however, the diagnosis of a brow presentation is usually confirmed by examination of a dilated cervix. The orbital ridge, eyes, nose, forehead, and anterior fontanelle are palpated. The mouth and chin are not palpable, thus excluding face presentation. Fetal ultrasound evaluation again notes a hyperextended neck.

As with face presentation, diagnosis is often made late in labor with half of cases occurring in the second stage of labor. The most common position is the mentum anterior, which occurs about twice as often as either transverse or posterior positions. A higher cesarean delivery rate occurs with a mentum transverse or posterior [ 3 ] position than with a mentum anterior position.

The mechanism of labor consists of the cardinal movements of engagement, descent, flexion, internal rotation, and the accessory movements of extension and external rotation. Intuitively, the cardinal movements of labor for a face presentation are not completely identical to those of a vertex presentation.

While descending into the pelvis, the natural contractile forces combined with the maternal pelvic architecture allow the fetal head to either flex or extend. In the vertex presentation, the vertex is flexed such that the chin rests on the fetal chest, allowing the suboccipitobregmatic diameter of approximately 9.5 cm to be the widest diameter through the maternal pelvis. This is the smallest of the diameters to negotiate the maternal pelvis. Following engagement in the face presentation, descent is made. The widest diameter of the fetal head negotiating the pelvis is the trachelobregmatic or submentobregmatic diameter, which is 10.2 cm (0.7 cm larger than the suboccipitobregmatic diameter). Because of this increased diameter, engagement does not occur until the face is at +2 station.

Fetuses with face presentation may initially begin labor in the brow position. Using x-ray pelvimetry in a series of 7 patients, Borrell and Ferstrom demonstrated that internal rotation occurs between the ischial spines and the ischial tuberosities, making the chin the presenting part, lower than in the vertex presentation. [ 4 , 5 ] Following internal rotation, the mentum is below the maternal symphysis, and delivery occurs by flexion of the fetal neck. As the face descends onto the perineum, the anterior fetal chin passes under the symphysis and flexion of the head occurs, making delivery possible with maternal expulsive forces.

The above mechanisms of labor in the term infant can occur only if the mentum is anterior and at term, only the mentum anterior face presentation is likely to deliver vaginally. If the mentum is posterior or transverse, the fetal neck is too short to span the length of the maternal sacrum and is already at the point of maximal extension. The head cannot deliver as it cannot extend any further through the symphysis and cesarean delivery is the safest route of delivery.

Fortunately, the mentum is anterior in over 60% of cases of face presentation, transverse in 10-12% of cases, and posterior only 20-25% of the time. Fetuses with the mentum transverse position usually rotate to the mentum anterior position, and 25-33% of fetuses with mentum posterior position rotate to a mentum anterior position. When the mentum is posterior, the neck, head and shoulders must enter the pelvis simultaneously, resulting in a diameter too large for the maternal pelvis to accommodate unless in the very preterm or small infant.

Three labor courses are possible when the fetal head engages in a brow presentation. The brow may convert to a vertex presentation, to a face presentation, or remain as a persistent brow presentation. More than 50% of brow presentations will convert to vertex or face presentation and labor courses are managed accordingly when spontaneous conversion occurs.

In the brow presentation, the occipitomental diameter, which is the largest diameter of the fetal head, is the presenting portion. Descent and internal rotation occur only with an adequate pelvis and if the face can fit under the pubic arch. While the head descends, it becomes wedged into the hollow of the sacrum. Downward pressure from uterine contractions and maternal expulsive forces may cause the mentum to extend anteriorly and low to present at the perineum as a mentum anterior face presentation.

If internal rotation does not occur, the occipitomental diameter, which measures 1.5 cm wider than the suboccipitobregmatic diameter and is thus the largest diameter of the fetal head, presents at the pelvic inlet. The head may engage but can descend only with significant molding. This molding and subsequent caput succedaneum over the forehead can become so extensive that identification of the brow by palpation is impossible late in labor. This may result in a missed diagnosis in a patient who presents later in active labor.

If the mentum is anterior and the forces of labor are directed toward the fetal occiput, flexing the head and pivoting the face under the pubic arch, there is conversion to a vertex occiput posterior position. If the occiput lies against the sacrum and the forces of labor are directed against the fetal mentum, the neck may extend further, leading to a face presentation.

The persistent brow presentation with subsequent delivery only occurs in cases of a large pelvis and/or a small infant. Women with gynecoid pelvis or multiparity may be given the option to labor; however, dysfunctional labor and cephalopelvic disproportion are more likely if this presentation persists.

Labor management of face and brow presentation requires close observation of labor progression because cephalopelvic disproportion, dysfunctional labor, and prolonged labor are much more common. As mentioned above, the trachelobregmatic or submentobregmatic diameters are larger than the suboccipitobregmatic diameter. Duration of labor with a face presentation is generally the same as duration of labor with a vertex presentation, although a prolonged labor may occur. As long as maternal or fetal compromise is not evident, labor with a face presentation may continue. [ 6 ] A persistent mentum posterior presentation is an indication for delivery by cesarean section.

Continuous electronic fetal heart rate monitoring is considered mandatory by many authors because of the increased incidence of abnormal fetal heart rate patterns and/or nonreassuring fetal heart rate patterns. [ 7 ] An internal fetal scalp electrode may be used, but very careful application of the electrode must be ensured. The mentum is the recommended site of application. Facial edema is common and can obscure the fetal facial anatomy and improper placement can lead to facial and ophthalmic injuries. Oxytocin can be used to augment labor using the same precautions as in a vertex presentation and the same criteria of assessment of uterine activity, adequacy of the pelvis, and reassuring fetal heart tracing.

Fetuses with face presentation can be delivered vaginally with overall success rates of 60-70%, while more than 20% of fetuses with face presentation require cesarean delivery. Cesarean delivery is performed for the usual obstetrical indications, including arrest of labor and nonreassuring fetal heart rate pattern.

Attempts to manually convert the face to vertex (Thom maneuver) or to rotate a posterior position to a more favorable anterior mentum position are rarely successful and are associated with high fetal morbidity and mortality and maternal morbidity, including cord prolapse, uterine rupture, and fetal cervical spine injury with neurological impairment. Given the availability and safety of cesarean delivery, internal rotation maneuvers are no longer justified unless cesarean section cannot be readily performed.

Internal podalic version and breech extraction are also no longer recommended in the modern management of the face presentation. [ 8 ]

Operative delivery with forceps must be approached with caution. Since engagement occurs when the face is at +2 position, forceps should only be applied to the face that has caused the perineum to bulge. Increased complications to both mother and fetus can occur [ 9 ] and operative delivery must be approached with caution or reserved when cesarean section is not readily available. Forceps may be used if the mentum is anterior. Although the landmarks are different, the application of any forceps is made as if the fetus were presenting directly in the occiput anterior position. The mouth substitutes for the posterior fontanelle, and the mentum substitutes for the occiput. Traction should be downward to maintain extension until the mentum passes under the symphysis, and then gradually elevated to allow the head to deliver by flexion. During delivery, hyperextension of the fetal head should be avoided.

As previously mentioned, the persistent brow presentation has a poor prognosis for vaginal delivery unless the fetus is small, premature, or the maternal pelvis is large. Expectant management is reasonable if labor is progressing well and the fetal well-being is assessed, as there can be spontaneous conversion to face or vertex presentation. The earlier in labor that brow presentation is diagnosed, the higher the likelihood of conversion. Minimal intervention during labor is recommended and some feel the use of oxytocin in the brow presentation is contraindicated.

The use of operative vaginal delivery or manual conversion of a brow to a more favorable presentation is contraindicated as the risks of perinatal morbidity and mortality are unacceptably high. Prolonged, dysfunctional, and arrest of labor are common, necessitating cesarean section delivery.

The incidence of perinatal morbidity and mortality and maternal morbidity has decreased due to the increased incidence of cesarean section delivery for malpresentation, including face and brow presentation.

Neonates delivered in the face presentation exhibit significant facial and skull edema, which usually resolves within 24-48 hours. Trauma during labor may cause tracheal and laryngeal edema immediately after delivery, which can result in neonatal respiratory distress. In addition, fetal anomalies or tumors, such as fetal goiters that may have contributed to fetal malpresentation, may make intubation difficult. Physicians with expertise in neonatal resuscitation should be present at delivery in the event that intubation is required. When a fetal anomaly has been previously diagnosed by ultrasonographic evaluation, the appropriate pediatric specialists should be consulted and informed at time of labor.

Bellussi F, Ghi T, Youssef A, et al. The use of intrapartum ultrasound to diagnose malpositions and cephalic malpresentations. Am J Obstet Gynecol . 2017 Dec. 217 (6):633-41. [QxMD MEDLINE Link] .

[Guideline] Ghi T, Eggebø T, Lees C, et al. ISUOG Practice Guidelines: intrapartum ultrasound. Ultrasound Obstet Gynecol . 2018 Jul. 52 (1):128-39. [QxMD MEDLINE Link] . [Full Text] .

Shaffer BL, Cheng YW, Vargas JE, Laros RK Jr, Caughey AB. Face presentation: predictors and delivery route. Am J Obstet Gynecol . 2006 May. 194(5):e10-2. [QxMD MEDLINE Link] .

Borell U, Fernstrom I. The mechanism of labour. Radiol Clin North Am . 1967 Apr. 5(1):73-85. [QxMD MEDLINE Link] .

Borell U, Fernstrom I. The mechanism of labour in face and brow presentation: a radiographic study. Acta Obstet Gynecol Scand . 1960. 39:626-44.

Gardberg M, Leonova Y, Laakkonen E. Malpresentations--impact on mode of delivery. Acta Obstet Gynecol Scand . 2011 May. 90(5):540-2. [QxMD MEDLINE Link] .

Collaris RJ, Oei SG. External cephalic version: a safe procedure? A systematic review of version-related risks. Acta Obstet Gynecol Scand . 2004 Jun. 83(6):511-8. [QxMD MEDLINE Link] .

Verspyck E, Bisson V, Gromez A, Resch B, Diguet A, Marpeau L. Prophylactic attempt at manual rotation in brow presentation at full dilatation. Acta Obstet Gynecol Scand . 2012 Nov. 91(11):1342-5. [QxMD MEDLINE Link] .

Johnson JH, Figueroa R, Garry D. Immediate maternal and neonatal effects of forceps and vacuum-assisted deliveries. Obstet Gynecol . 2004 Mar. 103(3):513-8. [QxMD MEDLINE Link] .

Benedetti TJ, Lowensohn RI, Truscott AM. Face presentation at term. Obstet Gynecol . 1980 Feb. 55(2):199-202. [QxMD MEDLINE Link] .

BROWNE AD, CARNEY D. OBSTETRICS IN GENERAL PRACTICE. MANAGEMENT OF MALPRESENTATIONS IN OBSTETRICS. Br Med J . 1964 May 16. 1(5393):1295-8. [QxMD MEDLINE Link] .

Campbell JM. Face presentation. Aust N Z J Obstet Gynaecol . 1965 Nov. 5(4):231-4. [QxMD MEDLINE Link] .

Contributor Information and Disclosures

Teresa Marino, MD Assistant Professor, Attending Physician, Division of Maternal-Fetal Medicine, Tufts Medical Center Disclosure: Nothing to disclose.

Francisco Talavera, PharmD, PhD Adjunct Assistant Professor, University of Nebraska Medical Center College of Pharmacy; Editor-in-Chief, Medscape Drug Reference Disclosure: Received salary from Medscape for employment. for: Medscape.

Carl V Smith, MD The Distinguished Chris J and Marie A Olson Chair of Obstetrics and Gynecology, Professor, Department of Obstetrics and Gynecology, Senior Associate Dean for Clinical Affairs, University of Nebraska Medical Center Carl V Smith, MD is a member of the following medical societies: American College of Obstetricians and Gynecologists , American Institute of Ultrasound in Medicine , Association of Professors of Gynecology and Obstetrics , Central Association of Obstetricians and Gynecologists , Society for Maternal-Fetal Medicine , Council of University Chairs of Obstetrics and Gynecology , Nebraska Medical Association Disclosure: Nothing to disclose.

Chitra M Iyer, MD, Perinatologist, Obstetrix Medical Group, Fort Worth, Texas.

Chitra M Iyer, MD is a member of the following medical societies: American College of Obstetricians and Gynecologists , Society of Maternal-Fetal Medicine .

Disclosure: Nothing to disclose.

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Face presentation at term: incidence, risk factors and influence on maternal and neonatal outcomes

• Maternal-Fetal Medicine
• Published: 09 April 2024
• Volume 310 , pages 923–931, ( 2024 )

Cite this article

• Yongqing Zhang 1   na1 ,
• Tiantian Fu 1   na1 ,
• Luping Chen 1 ,
• Yinluan Ouyang 1 ,
• Xiujun Han 1 &
• Danqing Chen   ORCID: orcid.org/0000-0002-0201-7215 1  

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The incidence, diagnosis, management and outcome of face presentation at term were analysed.

A retrospective, gestational age-matched case–control study including 27 singletons with face presentation at term was conducted between April 2006 and February 2021. For each case, four women who had the same gestational age and delivered in the same month with vertex position and singletons were selected as the controls (control group, n = 108). Conditional logistic regression was used to assess the risk factors of face presentation. The maternal and neonatal outcomes of the face presentation group were followed up.

The incidence of face presentation at term was 0.14‰. After conditional logistic regression, the two factors associated with face presentation were high parity (adjusted odds ratio [aOR] 2.76, 95% CI 1.19–6.39)] and amniotic fluid index > 18 cm (aOR 2.60, 95% CI 1.08–6.27). Among the 27 cases, the diagnosis was made before the onset of labor, during the latent phase of labor, during the active phase of labor, and during the cesarean section in 3.7% (1/27), 40.7% (11/27), 11.1% (3/27) and 44.4% (12/27) of cases, respectively. In one case of cervical dilation with a diameter of 5 cm, we innovatively used a vaginal speculum for rapid diagnosis of face presentation. The rate of cesarean section and postpartum haemorrhage ≥ 500 ml in the face presentation group was higher than that of the control group (88.9% vs. 13.9%, P  < 0.001, and 14.8% vs. 2.8%, P  = 0.024), but the Apgar scores were similar in both sets of newborns. Among the 27 cases of face presentation, there were three cases of adverse maternal and neonatal outcomes, including one case of neonatal right brachial plexus injury and two cases of severe laceration of the lower segment of the uterus with postpartum haemorrhage ≥ 1000 ml.

Conclusions

Face presentation was rare. Early diagnosis is difficult, and thus easily neglected. High parity and amniotic fluid index > 18 cm are risk factors for face presentation. An early diagnosis and proper management of face presentation could lead to good maternal and neonatal outcomes.

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Prognosis for deliveries in face presentation: a case–control study

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Acknowledgements

The authors wish to acknowledge Menglin Zhou, Zhengyun Chen and Guohui Yan for their valuable assistance for the manuscript.

No specific funding was obtained for this study.

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Yongqing Zhang and Tiantian Fu have contributed equally to this work.

Authors and Affiliations

Department of Obstetrics, School of Medicine, Women’s Hospital, Zhejiang University, 1st Xueshi Road, Hangzhou, 310006, Zhejiang, People’s Republic of China

Yongqing Zhang, Tiantian Fu, Luping Chen, Yinluan Ouyang, Xiujun Han & Danqing Chen

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YZ: conceptualization, methodology, writing—original draft. TF: conceptualization, formal analysis, writing—original draft. LC: data collection, follow-up. YO: investigation, resources. XH: investigation, formal analysis, supervision. DC: conceptualization, writing—review and editing, supervision. All authors read and approved the final manuscript.

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Correspondence to Xiujun Han or Danqing Chen .

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Our study was planned in accordance with the Declaration of Helsinki. Ethical approval was obtained from the Local Ethics Committee of the Women’s hospital, school of medicine, Zhejiang university ( Ethical No. IRB-20210211-R ).

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As this was a retrospective study, written informed consents were not obtained, but all patients’ records/information were anonymized before analysis. The images used in this paper (Figs. 1 , 2 , 3 ) were given informed consent by the pregnant woman.

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Zhang, Y., Fu, T., Chen, L. et al. Face presentation at term: incidence, risk factors and influence on maternal and neonatal outcomes. Arch Gynecol Obstet 310 , 923–931 (2024). https://doi.org/10.1007/s00404-024-07406-4

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Face presentation at term: incidence, risk factors and influence on maternal and neonatal outcomes

Affiliations.

• 1 Department of Obstetrics, School of Medicine, Women's Hospital, Zhejiang University, 1st Xueshi Road, Hangzhou, 310006, Zhejiang, People's Republic of China.
• 2 Department of Obstetrics, School of Medicine, Women's Hospital, Zhejiang University, 1st Xueshi Road, Hangzhou, 310006, Zhejiang, People's Republic of China. [email protected].
• 3 Department of Obstetrics, School of Medicine, Women's Hospital, Zhejiang University, 1st Xueshi Road, Hangzhou, 310006, Zhejiang, People's Republic of China. [email protected].
• PMID: 38594406
• DOI: 10.1007/s00404-024-07406-4

Objectives: The incidence, diagnosis, management and outcome of face presentation at term were analysed.

Methods: A retrospective, gestational age-matched case-control study including 27 singletons with face presentation at term was conducted between April 2006 and February 2021. For each case, four women who had the same gestational age and delivered in the same month with vertex position and singletons were selected as the controls (control group, n = 108). Conditional logistic regression was used to assess the risk factors of face presentation. The maternal and neonatal outcomes of the face presentation group were followed up.

Results: The incidence of face presentation at term was 0.14‰. After conditional logistic regression, the two factors associated with face presentation were high parity (adjusted odds ratio [aOR] 2.76, 95% CI 1.19-6.39)] and amniotic fluid index > 18 cm (aOR 2.60, 95% CI 1.08-6.27). Among the 27 cases, the diagnosis was made before the onset of labor, during the latent phase of labor, during the active phase of labor, and during the cesarean section in 3.7% (1/27), 40.7% (11/27), 11.1% (3/27) and 44.4% (12/27) of cases, respectively. In one case of cervical dilation with a diameter of 5 cm, we innovatively used a vaginal speculum for rapid diagnosis of face presentation. The rate of cesarean section and postpartum haemorrhage ≥ 500 ml in the face presentation group was higher than that of the control group (88.9% vs. 13.9%, P < 0.001, and 14.8% vs. 2.8%, P = 0.024), but the Apgar scores were similar in both sets of newborns. Among the 27 cases of face presentation, there were three cases of adverse maternal and neonatal outcomes, including one case of neonatal right brachial plexus injury and two cases of severe laceration of the lower segment of the uterus with postpartum haemorrhage ≥ 1000 ml.

Conclusions: Face presentation was rare. Early diagnosis is difficult, and thus easily neglected. High parity and amniotic fluid index > 18 cm are risk factors for face presentation. An early diagnosis and proper management of face presentation could lead to good maternal and neonatal outcomes.

Keywords: Brachial plexus injury; Face presentation; Postpartum haemorrhage; Risk factors; Term.

© 2024. The Author(s), under exclusive licence to Springer-Verlag GmbH Germany, part of Springer Nature.

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17 tips for facial expressions in speeches and presentations

The importance of facial expressions in public speaking

When the topic of body language appears in presentation skills training, the question comes up “Where to put my hands while speaking?”

Mimic is discussed rarely, if at all, with the hint of having a smile on your face. This is a pity because facial expressions can support the message. When facial expressions aren’t right, they can cause damage. What does not fit the personality and role of the speaker is unintentionally funny, damages credibility, and distracts.

This article deals with what it is worth paying attention to as a speaker concerning facial expressions.

Body language, facial expressions, and public speaking

So facial expressions are no longer important, 17 tips for facial expressions in your speeches and presentations, just ask me personally, related articles.

In addition to the content of the speech, as a verbal part, the way of presentation and the non-verbal behavior are of particular importance. These include gestures, eye contact, eye direction, body tension, leg posture, volume, intonation, and, often forgotten, pauses. Pauses before a message produce tension and after a message, they let the message work. In modern rhetoric, facial expressions have become less important than in the past. A facial expression that is too pronounced quickly has a theatrical and posed effect on the audience.

Mimic is important because public speakers who want to convince have to be authentic. And that includes lively facial expressions. Instead of orienting the facial expressions to Asian theater masks or the pantomime from the pedestrian zone, Method-Acting delivers better results. If you mean what you say, this also includes the corresponding emotional states. If you experience inwardly with all your senses what you verbalize, then your face provides the appropriate facial expression anyway. At least as long as you haven’t stopped it with nerve poison against wrinkles.

Leave that deadpan expression to poker players and some politicians. A good presenter realizes that appropriate facial expressions are a significant part of effective communication. Facial expressions are often the key determinant of the meaning behind the message. The audience is watching a speaker’s face during a presentation. When you speak, your face tells more clearly than any other part of your body about your attitudes, feelings, and emotions.

Your impact as a speaker depends heavily on your body language . You probably have control over the words you speak, are you sure you have control over what you say with your body language?

1. Authentic, authentic, authentic

Effective body language supports the message and conveys a strong image of the speaker. Anything that does not fit the personality and role of a public speaker and the message will unintentionally appear funny, damage credibility, and distract from the content and message. Those who mean what they say can automatically display the appropriate facial expressions. This is a frequent topic in my presentation training . Few speakers know how they affect the audience. Professional analysis is very revealing here.

2. Smiling is contagious

Unfortunately, many people lose their lively facial expressions under the pressure of speaking in front of an audience. Their faces solidify into a mask. Free your face right at the beginning. For example, when you are welcoming the audience, smile!

With a smile or even a laugh, it is easier to build a bridge with other people. This looks open and friendly. A real smile comes from within and is based on the right mental attitude and not on a mask. Such a permanent grin looks different from a real smile, which is called a Duchenne smile . The Duchenne smile is named after Guillaume Duchenne , a French anatomist who studied many expressions of emotion, focusing on the smile of pure enjoyment. He identified the facial movements that make this genuine smile different from artificial types of smiles. A Duchenne smile is a natural smile of enjoyment, made by contracting the zygomatic major muscle and the orbicularis oculi muscle. In my words; the mouth, the eyes, and the wrinkles around the eyes are involved, and the smile, the cheeks lifting.

3. Emotions

It is the presenter’s connection to the words that can bring them to life for the audience. Experience inwardly intensively what you want to convey, and the facial expressions will reflect it. Less is more! Please do not grimace.

4. Lead with your gaze

The audience will register where you’re looking. In this way, you can direct the attention of the audience with your gaze. Look where the audience should look.

And be careful with misunderstandings. If you keep looking at the door, it will look as if you would like to escape.

5. Eye contact is connecting

If they don’t fit, they can undermine any of your words.

Good speakers know how important facial expressions are. Effective presenters engage one person at a time, focusing long enough to complete a natural phrase and watch it sink in for a moment. With a smile, they convey appreciation to the audience.

Keep looking at all faces, and be attentive. Return a smile. Use clues such as a frown as an occasion to repeat or inquire about a statement in other words.

6. Pulling up the corners of your mouth on one side

Some facial expressions can irritate. One-sided lifting of the corners of the mouth can be interpreted as a sign of superiority, and the speaker is then accused of arrogance or cynicism.

7. Enduring smile

A permanent smile seems artificial, complacent, or even debilitating. Speakers don’t do themselves any favors.

Such behavior is reminiscent of bad show presenters or used car salesmen from US films. If you smile without a break, you make your counterpart suspicious. Beware of bad facial expressions, i.e. a superimposed smile.

If there are moments during your speech when you want to make the audience think, then that doesn’t fit. When you put on an artificial smile, nobody takes you seriously.

8. A tense jaw

Someone who presses their teeth vigorously against each other may look angry and aggressive, or at least cramped.

9. Smiling and showing teeth

What is more common in the USA is more irritating in Germany, for example, than piranha smiles. Superficiality and an unfair sales mentality are easily assumed.

10. Grasping the nose or the mouth

Do not touch your nose, mouth, or chin during your speech. This is a classic sign of insecurity and is quickly perceived as negative by your audience. Since Pinocchio this has been considered a sign of lies, and why should you voluntarily sow doubt?

11. Other delicate facial expressions

In my articles, Body Language Soothes or harms in delicate situations and 12 tips on how to promote confidence through body language, you will find advice on how body language can help and how it can hurt.

12. Adapt your facial expressions to the size of the group.

As your audience grows, your facial expressions should become more pronounced. If the audience in the last row is not able to read your face, your facial expression will be perceived as a neutral expression and thus as your lack of interest.

13. Explore the effect of facial expressions

The facial expression usually has a small part in the presentation, which is why its role tends to be underestimated. It plays an important role in convincing the speaker and the message. It is worth exploring the impact.

Using all the various muscles that precisely control the mouth, lips, eyes, nose, forehead, and jaw, the human face is estimated to be capable of more than 10,000 different expressions. Explore different ways to use facial expressions. Start with the most common facial expressions and emotions.

There are seven universally recognized emotions shown through facial expressions:

Regardless of culture, these expressions are the same all over the world. They may differ in intensity.

14. Observe your audience

Just as your facial expressions provide insight into your emotions, your audience’s facial expressions provide insight into their emotional world.

Read the facial expressions of your audience. If the audience’s expressions are expressionless, for example, there is a possibility that they are intellectually elsewhere because they are bored. Or their facial expressions convey joy and excitement, or they are eagerly receptive or…

By reading your audience’s facial expressions, you are better able to make spontaneous decisions and adjustments to capture attention.

15. Using a lectern or manuscript

Wherever your speech manuscript is located, whether as a pile of paper on the lectern or as key point cards in your hand, always avoid looking at the notes all the time. Learn from me how to keep in touch with the audience.

16. Practice, practice, practice

As with any presentation skill, facial expression requires practice to develop it to be both authentic and effective. Presenters who care deeply about their message tend to use their entire bodies to support the message.

Practice your presentation and the things you have experienced with me in front of a mirror to concentrate exclusively on your facial expressions during a rehearsal. While practicing in front of the mirror, see if your facial expressions convey the mood you want to create. If your face isn’t showing any emotion, stop, refocus, and do it again. This will help you to explore your expression playfully. The best way to do this is with professional support.

17. Support

As a professional speech coach , I will not practice masks with you but will point out potential misunderstandings and promote corresponding situations from within.

Preparation of important speeches and presentations

Those who do not speak are not heard, and even those who speak up are not always successful. There are a few more steps that need to be mastered.

Do you want to convince with your message and also as a personality? Then I will help you to prepare your speeches and presentations. You determine the scope. At least, I recommend a test run with professional feedback for you and your message. Then you will know how you and your content are perceived, what you should do, and what you should leave out, where there is potential. Why do you want to get such helpful feedback so late after your real performance? Then it is too late for adjustments. Benefit from the advantage. My definition of luck: Preparation meets opportunity.

You can best estimate for yourself where the effort is worthwhile concerning the expected benefit. Here you will find the fees for my support (communication, psychology, language, structure, voice, body language, storytelling, rhetorical means, media such as PowerPoint and Co., etc.)

You are not in Berlin right now? Then choose meetings with me via telephone or video support . Whereby, there are quite good reasons for a trip to Berlin .

By the way, many people suffer from such intense stage fright in front of an audience, and therefore their performance lags behind their possibilities. Too bad, because with my help performance in a good condition is possible. Just in case...

A good start: Professional feedback with suggestions for improvement​

How persuasive are you and your messages in speeches and presentations? How good are you at the 111+ most important presentation skills? I have been analyzing speeches since 1998. After evaluating 14,375 speeches and presentations, and numerous mistakes of my own, most of which I only discovered after a delay, I can tell you exactly what works with which audience. Let me give you the feedback that will help you get ahead. You will receive essential feedback and recommendations, as well as the impulses you need to persuade your audience in concrete situations.

Are you interested? If so, here is how to get helpful feedback with recommendations for improving your speeches and presentations.

Please post any questions that may be of interest to other readers in the comments. Looking for professional help?

If you are interested in coaching, training or consulting, if you have organizational questions, or if you want to make an appointment, you can reach me best via this contact form (you can choose whether you want to enter your personal data) or via e-mail ( [email protected] ). The privacy policy can be found here.

Transparency is important. That is why you will find answers to frequently asked questions already here , for example about me ( profile ), the services , the fees and getting to know me . If you like what you see, I look forward to working with you.

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What do you pay attention to in facial expressions during conversations, speeches, and presentations?

Those are many factors.

You make an important point that if the subject you are speaking on does not excite you then it will not excite the audience. Listening to a speaker talks about something and you can tell that they have no passion, it will be incredibly difficult to be able to hold attention. The facial expression plays a big role in showing the enthusiasm. When you speak, your face – more clearly than any other part of your body – communicates to your audience your attitudes, feelings, and emotions.

What can facial expressions like microexpressions tell us?

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Use grounding for presence and a feeling confident in speeches and presentations. More than just a remedy for stage fright.

Body language: What can actually be read from the eyes? Not only wishes!

What can be read from the eyes? More than wishes! The eyes have a big part in human facial expressions. There is a reason why the eyes are called the mirror of the soul. They reveal a lot about our feelings and thoughts, no matter if we want it or not. Eyes can smile, radiate joy, permeate, agree, question, doubt or reject. Learn to read body language.

15 tips on how to stand up for your conviction: Be brave, speak up!

Some people have an opinion that deserves attention. Often, however, this opinion is not heard. Then it is time to decide whether to keep it that way or to share the point of view more clearly with others. Not everyone dares this step. What about you?

This article is a short excerpt from the more comprehensive course materials my clients receive in group or individual training or coaching .

Published: June 27, 2019 Author: Karsten Noack Revision: October 6, 2021 Translation: ./. German version: https://www.karstennoack.de/rhetorik-mimik-koerpersprache/ K: H: T: RR #124710

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noun as in coming into sight

Strongest matches

arrival , debut , display , presence , presentation

Strong matches

actualization , advent , appearing , coming , emergence , entrance , exhibition , introduction , manifestation , materialization , representation , rise , unveiling

Weak matches

showing up , turning up

noun as in outward aspect, characteristic

character , image , look , presence , presentation

air , attitude , bearing , blind , carriage , cast , condition , countenance , demeanor , dress , expression , face , fashion , feature , figure , form , front , guise , looks , manner , mannerism , mien , mode , outline , pose , screen , semblance , shape , stamp

noun as in outward show; pretense

Strongest match

aura , beard , blind , countenance , dream , facade , front , guise , idea , illusion , impression , mirage , phenomenon , reflection , screen , semblance , sound , specter , vision

Example Sentences

Recently, Google has been testing a new dark theme appearance in the search results.

For instance, on a high-end console or PC, the models can start with one of 30 stock styles that render individual strands of hair in real-time for a super-realistic appearance.

If you are in this beta and you have access to the new appearance controls in Google Search, you will have an option in search settings to toggle on or off dark theme.

Cheerleaders are paid for attending practices and making appearances on the team’s behalf during the offseason.

The highlight was an appearance and brief remarks from Miami Heat Coach Erik Spoelstra, whose mother is Filipino.

He knew that a public appearance with Duke could be disastrous.

In his brief appearance today, Scalise never mentioned Duke.

The healthier appearance and civilian clothing are very peculiar.

The majority of these stories are making their first appearance online.

An appearance in even a third-tier bowl is worth a couple million dollars.

I was rather awed by his imposing appearance, and advanced timidly to the doors, which were of glass, and pulled the bell.

And once more, she found herself desiring to be like Janet--not only in appearance, but in soft manner and tone.

Where the dampness is excessive the fronds take on an unhealthy appearance, and mould may appear.

Keep closely covered with a bell glass and, in a few weeks, more or less, the baby Ferns will start to put in an appearance.

This gave the house a very cheerful appearance, as if it were constantly on a broad grin.

Related Words

Words related to appearance are not direct synonyms, but are associated with the word appearance . Browse related words to learn more about word associations.

noun as in beginning or arrival of something anticipated

noun as in pretended behavior to make an impression

• artificiality
• false front
• going Hollywood
• insincerity
• pretentiousness
• putting on airs
• showing off

noun as in distinctive quality or character; style

• affectation
• comportment

noun as in coming to a destination

• debarkation
• disembarkation

noun as in visible feature

• countenance

Viewing 5 / 85 related words

From Roget's 21st Century Thesaurus, Third Edition Copyright © 2013 by the Philip Lief Group.

What's the opposite of Meaning of the word Words that rhyme with Sentences with the word Translate to Find Words Use * for blank tiles (max 2) Use * for blank spaces Find the of Pronounce the word in Find Names     Appearance ✓ Use device theme   ✓ Dark theme ✓ Light theme ? ? Here's a list of from our that you can use instead. ▲ ) ▲ creased into a warm smile.” .” told of her joy.” of the large alley wall was emblazoned with impressive street art.” is hard and shiny because the molecules that make up its sugar coating link to form long, interlocked chains.” of the industry is changing at a rapid rate.” for his audience.” to take on the incumbent.” when told we were having Brussels sprouts for dinner said it all.” can be pretty tough.” in the crowd.” as a base.” ) A person's mouth the challenge of change everywhere.” the fact that changes must be made?” the magnificent ocean.” a stinging rebuke from your peers.” him with the need to sort out their credit card debt.” our dining room and kitchen cabinets with laminate.” the suspect at all times and do not lose sight of him.” Use * for blank tiles (max 2) Use * for blank spaces Related Words and Phrases Bottom_desktop desktop:[300x250]. go Word Tools Finders & Helpers Apps More Synonyms Copyright WordHippo © 2024 Cambridge Dictionary +Plus Synonyms and antonyms of presentation in English Presentation, synonyms and examples, see words related to presentation, presentation | american thesaurus. Word of the Day one-hit wonder Your browser doesn't support HTML5 audio a performer of popular music who makes one successful recording but then no others A finger in every pie: phrases with the word ‘finger’ Learn more with +Plus Recent and Recommended {{#preferredDictionaries}} {{name}} {{/preferredDictionaries}} Definitions Clear explanations of natural written and spoken English English Learner’s Dictionary Essential British English Essential American English Grammar and thesaurus Usage explanations of natural written and spoken English Grammar Thesaurus Pronunciation British and American pronunciations with audio English Pronunciation English–Chinese (Simplified) Chinese (Simplified)–English English–Chinese (Traditional) Chinese (Traditional)–English English–Dutch Dutch–English English–French French–English English–German German–English English–Indonesian Indonesian–English English–Italian Italian–English English–Japanese Japanese–English English–Norwegian Norwegian–English English–Polish Polish–English English–Portuguese Portuguese–English English–Spanish Spanish–English English–Swedish Swedish–English Dictionary +Plus Word Lists To add ${headword} to a word list please sign up or log in. Add ${headword} to one of your lists below, or create a new one. {{message}} Something went wrong. There was a problem sending your report. Help Center Synonyms for Presentation 1 978 other terms for presentation - words and phrases with similar meaning. 206 IMAGES Diagnosis of face presentation Face Presentation: Causes, Diagnosis, Management, Complications by PPT Face Presentation Face presentation Face Presentation VIDEO Should you do zoom meetings or face to face meetings? #shorts Mastering the Meaning of "An About-Face" in English Face presentation Face presentation Pregnancy face presentation baby 🥰 🍼 waight4:30 kilo Parts of the Face COMMENTS 26 Words and Phrases for Face Presentation Another way to say Face Presentation? Synonyms for Face Presentation (other words and phrases for Face Presentation). ... 26 other terms for face presentation- words and phrases with similar meaning. Lists. synonyms. antonyms. definitions. sentences. thesaurus. words. phrases. suggest new. malpresentation. naegele obliquity. sincipital ... Delivery, Face and Brow Presentation The term presentation describes the leading part of the fetus or the anatomical structure closest to the maternal pelvic inlet during labor. The presentation can roughly be divided into the following classifications: cephalic, breech, shoulder, and compound. Cephalic presentation is the most common and can be further subclassified as vertex, sinciput, brow, face, and chin. The most common ... Face presentation synonyms, face presentation antonyms Synonyms for face presentation in Free Thesaurus. Antonyms for face presentation. 63 synonyms for presentation: giving, award, offering, donation, investiture ... Face Presentation Birth: Is it Dangerous? A face presentation birth can result in a host of birth injuries, such as: Asphyxia (oxygen deprivation) Trauma to the face and head. Spinal cord injuries. Fetal heart rate issues. Cerebral palsy and other brain injuries. Breathing problems (due to tracheal and laryngeal injuries) Fetal distress. Fetal Presentation, Position, and Lie (Including Breech Presentation) Presentation refers to the part of the fetus's body that leads the way out through the birth canal (called the presenting part). Usually, the head leads the way, but sometimes the buttocks (breech presentation), shoulder, or face leads the way. Position refers to whether the fetus is facing backward (occiput anterior) or forward (occiput ... Management of face presentation, face and lip edema in a primary Introduction. Face presentation is a rare unanticipated obstetric event characterized by a longitudinal lie and full extension of the foetal head on the neck with the occiput against the upper back [1-3].Face presentation occurs in 0.1-0.2% of deliveries [3-5] but is more common in black women and in multiparous women [].Studies have shown that 60 per cent of face presentations have one or ... Face and Brow Presentation: Overview, Background, Mechanism ... In a brow presentation, the fetal head is midway between full flexion (vertex) and hyperextension (face) along a longitudinal axis. The presenting portion of the fetal head is between the orbital ridge and the anterior fontanel. The face and chin are not included. The frontal bones are the point of designation and can present (as with the ... Face Presentation type of cephalic presentation in which the presenting part is the face, the area between chin and glabella. The incidence varies from 1 in 500 to 1 in 1000 deliveries. Primary face presentation is rare. Secondary face presentation caused by exten-sion of head during labor is common. Thus, the diagnosis is usually made during active phase of ... Face presentation at term: incidence, risk factors and influence on Objectives The incidence, diagnosis, management and outcome of face presentation at term were analysed. Methods A retrospective, gestational age-matched case-control study including 27 singletons with face presentation at term was conducted between April 2006 and February 2021. For each case, four women who had the same gestational age and delivered in the same month with vertex position and ... Face presentation at term: incidence, risk factors and influence on The maternal and neonatal outcomes of the face presentation group were followed up. Results: The incidence of face presentation at term was 0.14‰. After conditional logistic regression, the two factors associated with face presentation were high parity (adjusted odds ratio [aOR] 2.76, 95% CI 1.19-6.39)] and amniotic fluid index > 18 cm (aOR 2 ... Cephalic presentation Face presentations account for less than 1% of presentations at term. In the sinicipital presentation, the large fontanelle is the presenting part; with further labor the head will either flex or extend more so that in the end this presentation leads to a vertex or face presentation. [1] In the brow presentation, the head is slightly extended ... Synonyms for Face-to-face communication Another way to say Face-to-face Communication? Synonyms for Face-to-face Communication (other words and phrases for Face-to-face Communication). 17 tips for facial expressions in speeches and presentations If the audience in the last row is not able to read your face, your facial expression will be perceived as a neutral expression and thus as your lack of interest. 13. Explore the effect of facial expressions . The facial expression usually has a small part in the presentation, which is why its role tends to be underestimated. 234 Synonyms & Antonyms for FACE Find 234 different ways to say FACE, along with antonyms, related words, and example sentences at Thesaurus.com. 41 Synonyms & Antonyms for PRESENTATION Find 41 different ways to say PRESENTATION, along with antonyms, related words, and example sentences at Thesaurus.com. Synonyms for Face-to-face meeting Another way to say Face-to-face Meeting? Synonyms for Face-to-face Meeting (other words and phrases for Face-to-face Meeting). 99 Synonyms & Antonyms for APPEARANCE Find 99 different ways to say APPEARANCE, along with antonyms, related words, and example sentences at Thesaurus.com. What is another word for presentation assortment. aligning. standardization. standardisation. procedure. computation. more . "The book's presentation allows for flexibility in choice, sequence, and degree of sophistication with which topics are dealt with.". Face-to-face Presentation synonyms direct presentation. in-person presentation. in-the-flesh presentation. live presentation. on-site presentation. personal presentation. physical presentation. traditional presentation. Another way to say Face-to-face Presentation? What is another word for face? Synonyms for face include countenance, mug, kisser, visage, features, profile, clock, dial, physiognomy and phiz. Find more similar words at wordhippo.com! Synonyms and antonyms of presentation in English PRESENTATION - Synonyms, related words and examples | Cambridge English Thesaurus Presentation synonyms 1 978 other terms for presentation- words and phrases with similar meaning assignment essay homework paper phd report resume review thesis