8.4.2 Diagnosis of face presentation
Face presentation may not be easily detected by abdominal palpation, especially if the chin is in the posterior position. On abdominal examination, you may feel irregular shapes, formed because the fetal spine is curved in an ‘S’ shape. However, on vaginal examination, you can detect face presentation because:
- The presenting part will be high, soft and irregular.
- When the cervix is sufficiently dilated, you may be able to feel parts of the face, such as the orbital ridges above the eyes, the nose or mouth, gums, or bony chin.
- If the membranes are ruptured, the baby may suck your examining finger!
But as labour progresses, the baby’s face becomes oedematous (swollen with fluid), making it more difficult to distinguish from the soft shape you will feel in a breech presentation.