Face and brow presentation: Independent risk factors

Asher Bashiri, Eliezer Burstein, Juri Bar-David, Amalia Levy, Moshe Mazor

Research output: Contribution to journalArticlepeer-review

14 Scopus citations

Abstract

Objectives. The objectives of this study were to determine clinical characteristics including pregnancy and delivery outcome, among patients with face/brow presentation, and to investigate independent risk factors for these malpresentations. Methods. This was a retrospective cohort study comparing all singleton pregnancies of patients with and without face/brow presentation. Deliveries occurred during the years 1988-2002 at the Soroka University Medical Center. Stratified analyses using a multiple logistic regression model were performed to control for confounders. Results. Two hundred and nineteen cases were included in the study out of 130,247 deliveries with vertex presentation, giving a prevalence for face/brow presentation of 0.17%. No significant difference was found with regard to maternal age and gravidity between the control and study groups, but the primiparity rate was lower in the study group (20.4% vs.14.6%, p = 0.034). There was a significantly higher rate of previous history of cesarean delivery (CD), polyhydramnios, non-progressive labor, and non-reassuring fetal heart rate in the study group, but the rate of hypertensive disorders was lower. The prevalence of congenital anomalies was higher in the study group than in the control group, 7.3% vs. 3.6%, respectively. Also the CD rate in the study group was 67.1% as compared to 8.6% in the control group (p < 0.001). In contrast, neonatal outcome was not different between groups, including Apgar scores and perinatal mortality (0.5% vs. 1.2%, p = NS). In a logistic regression analysis model for face/brow presentation, the independent risk factors were fetal malformations (OR = 2.0), polyhydramnios (OR = 2.77) and primiparity (OR = 0.65). Conclusion. Face/brow presentation was associated with several adverse pregnancy outcomes, although there was a favorable neonatal outcome. Independent risk factors for face/brow presentation were fetal malformations and polyhydramnios, but primiparity had a protective effect.

Original languageEnglish
Pages (from-to)357-360
Number of pages4
JournalJournal of Maternal-Fetal and Neonatal Medicine
Volume21
Issue number6
DOIs
StatePublished - 22 Jul 2008
Externally publishedYes

Keywords

  • Brow presentation
  • Cesarean delivery
  • Face presentation
  • Fetal malformations
  • Polyhydramnios
  • Pregnancy outcome
  • Risk factors

ASJC Scopus subject areas

  • Pediatrics, Perinatology, and Child Health
  • Obstetrics and Gynecology

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