Exxcellence pearls: malpresentation brow, face, compound

Question 0

What are the two basic principles of managing malpresentation?

Answer 0

1. They are managed expectantly awaiting spontaneous resolution
2. Delivery is generally impossible without resolution

Question 1

What face presentation can deliver vaginally?

Answer 1

Mentum anterior

Question 2

How is mentum posterior presentation managed?

Answer 2

Expectant management, waiting for the head to rotate to a mentum anterior position. Manual or forceps rotation is not recommended. If presentation remains mentum posterior cesarean delivery is recommended.

Question 3

How is compound presentation managed?

Answer 3

Expectant management is usually sufficient but if you fetal part does not retract it can be swept away with gentle manual pressure.