Brow presentation is a deflection arrival. It is the rarest
of presentation amomalies and occurs in about 10000 births. The fetal is
presented with the forehead part, that is, between the eyes and the anterior
fontanel.
On vaginal examination, nose root, around the eyes and
anterior fontanel are handled. The fetal head is in extension, but it is not as
advanced as the face presentation. Ultrasonography can help in diagnosis.
The fetus enters the pelvis with the widest diameter of the
head, the occiputomental diameter. If the forehead does not change from occiput
to normal, normal delivery is not possible. If the forehead continues, cesarean
is required. No vacuum or forceps are applied.
Risk
factors:
- Anencephaly is the most important risk factor
- Premature
- Grand multiparite
- Fetal anomalies
- Polyhydramnios
- Large fetus, baby's neck is thick
- The cord on the neck of the fetus
If the head is partially deflected and is presented with an
anterior fontanel, it is called syncypute presentation and often returns to
normal vertex arrival.
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