Face presentation at term: a forgotten issue.

AIM: To determine factors associated with face presentation of term fetuses delivered.

METHODS: Of 34,480 consecutive, term deliveries of uncomplicated pregnancies within a 3-year period, all live, singleton term fetuses with cephalic presentation in which no lethal anomalies occurred that were diagnosed with a face presentation were studied. Factors that may have contributed to the etiology of the presentation including age, parity and fetal size were evaluated. Ultrasonographic evaluation was recorded.

RESULTS: Fifty cases were diagnosed with an incidence of 0.14%. Parity was not associated with face presentation. Birthweight of 4000 g or more indicated an increased risk of approximately 2.9-fold, whereas fetuses weighing 3000-3499 g were found to have a relatively decreased risk of face presentation when compared with the general obstetrics group (P = 0.015 and 0.001, risk ratio = 2.948 and 0.450, respectively). With physical examination, only 70% were diagnosed correctly.

CONCLUSION: Face presentation is a rare event and birthweight more than 4000 g was found to be associated with face presentation. Parity is not an associated factor.