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  • Brow Presentation

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    Israel Wosene
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    This document outlines the definition, mechanisms of labor, diagnosis, and management of brow presentations during childbirth. A brow presentation occurs when the fetal presenting part felt during examination is the area between the eyebrows and hairline. Brow presentations are often transient early in labor but can persist. Diagnosis involves palpation and vaginal exams to determine fetal position and rule out issues. Management depends on labor progression - early labor aims to monitor reversion to safer positions, while late labor requires expedited delivery via C-section due to risks of mechanical obstruction.

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    basic obstetrics

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    This document outlines the definition, mechanisms of labor, diagnosis, and management of brow presentations during childbirth. A brow presentation occurs when the fetal presenting part felt during examination is the area between the eyebrows and hairline. Brow presentations are often transient early in labor but can persist. Diagnosis involves palpation and vaginal exams to determine fetal position and rule out issues. Management depends on labor progression - early labor aims to monitor reversion to safer positions, while late labor requires expedited delivery via C-section due to risks of mechanical obstruction.

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    © All Rights Reserved
    Download as PPTX, PDF, TXT or read online from Scribd
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    7 views6 pages

    Brow Presentation

    Uploaded by

    Israel Wosene
    This document outlines the definition, mechanisms of labor, diagnosis, and management of brow presentations during childbirth. A brow presentation occurs when the fetal presenting part felt during examination is the area between the eyebrows and hairline. Brow presentations are often transient early in labor but can persist. Diagnosis involves palpation and vaginal exams to determine fetal position and rule out issues. Management depends on labor progression - early labor aims to monitor reversion to safer positions, while late labor requires expedited delivery via C-section due to risks of mechanical obstruction.

    Copyright:

    © All Rights Reserved
    Download as PPTX, PDF, TXT or read online from Scribd
    Flag for inappropriate content
    of 6

    Brow Presentation

    Asheber Gaym M.D.


    January 2009
    Outline

    • Definition of brow presentation


    • Mechanisms of labor in brow presentation
    • Diagnosis of brow presentation
    • Outline of management of brow presentation

    Asheber Gaym,2009 2
    Definitions

    • Brow presentation is when the fetal presenting part


    felt on digital exam is the area bounded by the supra
    orbital ridges and root of the nose anteriorly and the
    coronal sutures and anterior fontanel posteriorly
    • Presenting diameters in brow presentation:
    – Biparietal diameter – 9.5 cms
    – Mentovertical diameter- 13 cms
    • Most brow presentations at term are transitory
    presentations in early labor

    Asheber Gaym,2009 3
    Mechanisms of Labor in Brow Presentation

    • Brow presentation is often a transitory


    presentation in early labor as the head is
    descending and engaging
    • With further descent, the head either flexes to a
    vertex or fully extends to a face presentation
    • On rare occasions in a premature fetus and a
    capacious pelvis the brow can be delivered as such
    • If unattended, a persistent brow in a mature fetus
    will lead to mechanical obstruction above the mid
    pelvis or even at the inlet

    Asheber Gaym,2009 4
    Diagnosis of Brow Presentation

    • Leopold’s palpation- not much indication


    except perhaps a “ military” attitude with both
    cephalic prominences at the same level
    • On vaginal exam- the brow area of the fetal
    skull is felt through the cervix
    – Check for presence of edema over the brow
    – Careful clinical pelvimetry should be performed
    early in labor to rule out a contracted pelvis
    – Also rule out presence of cord

    Asheber Gaym,2009 5
    Outline of Management
    Early labor Late labor

    If in early labor: If late in labor:


    •Assess pelvic capacity •Expedite delivery by caesarean section as
    •Assess fetal condition the chance of vaginal delivery is slim
    •Assess for presence of cord •Induction and augmentation of labor is
    •Assess for the presence of other contraindicated in a fetus with a brow
    contraindications for vaginal delivery presentation
    •If all the above are normal, monitor labor •VBAC is contraindicated in a fetus with
    progress and await spontaneous reversion brow presentation
    to face or vertex

    Asheber Gaym,2009 6

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