Brow Presentation

Subject: Midwifery II (Theory)

Overview

The fetal head is partially stretched in the brow presentation, and the frontal bone, which is bordered by the orbital ridges and the anterior fontanelle, is lying at the pelvic brim. Multiparity with pendulous abdomen, anterior obliquity of the uterus, constricted pelvis, and Polyhydramnios are the maternal reasons of brow presentation. Congenital anomalies, a twisted cord, and elevated tone in the neck muscles' extensor group are the fetal causes. If brow appearance is diagnosed during pregnancy, nothing needs to be done. It's conceivable that the face will adjust on its own. Plan an elective caesarean section if all else fails. Allow labor to continue for a brief time if there is no fetal discomfort; on rare occasions, spontaneous flexion may happen, resulting in vertex presentation.

Brow presentation

The fetal head is partially stretched in the brow presentation, and the frontal bone, which is bordered by the orbital ridges and the anterior fontanelle, is lying at the pelvic brim.

Causes

Maternal cause

  • Multiparity with pendulous abdomen
  • Anterior obliquity of the uterus
  • Contracted pelvis
  • Polyhydramnios

Fetal cause

  • Congenital abnormalities
  • Twist of the cord
  • Increased tone of the extensor group of neck muscles

Management

  • If discovered during pregnancy, nothing can be done. It's conceivable that the face will adjust on its own. Plan an elective caesarean section if all else fails.
  • Because vaginal birth is uncommon, the midwife should prepare for possible problems.
  • Vaginal delivery is possible if the baby is large and little in the pelvis. The maxilla rotates forward when the brow approaches the pelvic floor, and the head is born by an occipito posterior position mechanism.
  • Allow labor to continue for a brief period of time if there is no fetal distress. Vertex presentation may arise as a result of this.
  • Plan for a caesarean section if the head doesn't descend and the brow presentation continues.

 
Things to remember
  • In the brow presentation, the fetal head is partially extended with the frontal bone, which is bounded by the anterior fontanelle and the orbital ridges, lying at the pelvic brim.
  • Maternal causes of Brow presentation are multiparity with pendulous abdomen, anterior obliquity of the uterus, contracted pelvis and Polyhydramnios.
  • And the Fetal cause are congenital abnormalities,twist of the cord and increased tone of the extensor group of neck muscles.
  • Management of brow presentation are during pregnancy, if diagnosed nothing to be done . spontaneous correction into the face is likely to occur.
  • If fails plan for elective caesarean section.If there is no fetal distress allow labor to continue for short , occasionally spontaneous flexion May occur resulting in vertex presentation.
Questions and Answers

Brow Presentation

In the brow presentation, the fetal head is partially extended with the frontal bone, which is bounded by the anterior fontanelle and the orbital ridges, lying at the pelvic brim.

Causes

Maternal Causes

  • Multiparity with pendulous abdomen,
  • Anterior obliquity of the uterus,
  • Contracted pelvis,
  • Polyhydramnios.

Fetal Cause

  • Congenital abnormalities,
  • Twist of the cord,
  • Increased tone of the extensor group of neck muscles.

Management

  • If discovered during pregnancy, nothing can be done. It's conceivable that the face will adjust on its own. Plan an elective caesarean section if all else fails.
  • Because vaginal birth is uncommon, the midwife should prepare for possible problems.
  • Vaginal birth is possible if the baby is big and little in the pelvis. The maxilla moves forward when the brow approaches the pelvic floor, and the head is born by an occipito posterior position mechanism.
  • Allow labor to continue for a brief period of time if there is no fetal distress. Vertex presentation may occur as a result of this.
  • Plan for a caesarean section if the head doesn't descend and the brow presentation continues.

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