Face presentation: predictors and delivery route.

OBJECTIVE: We sought to identify associated characteristics of face presentation and to examine factors that were associated with mode of delivery in the setting of face presentation.

STUDY DESIGN: This was a retrospective cohort study of women who were diagnosed with face presentation during labor. We examined maternal, fetal, and labor characteristics to determine the associations and predictors of cesarean delivery.

RESULTS: Fetuses in face presentation were more likely preterm, < 2500 g, and black. An Apgar score of < 7 at 5 minutes was more common in face presentation (10.9%) compared with vertex presentation (4.4%; P = .018). Rates of umbilical artery base excess < -12 or pH < 7.0 were not different. Cesarean delivery was less common in women who received oxytocin (adjusted odds ratio, 0.18; 95% CI, 0.03-0.95) and in women with mentum anterior (14%) as compared with mentum posterior presentation (85%; P < .001).

CONCLUSION: This study confirms the association between face presentation and prematurity. The association with black ethnicity may be related to differences in pelvic anatomy. Although face presentation was associated with decreased Apgar scores, no other indicators of fetal asphyxia were identified. Cesarean delivery rates were higher in women with mentum posterior face presentation and in women who did not receive oxytocin.