Intrapartum translabial ultrasound demonstration of face presentation during first stage of labor

TLDR

Face presentation is a rare non‑vertex malpresentation that can be identified sonographically, and this case reports intrapartum translabial ultrasound diagnosis during the first stage of labor in a multigravida at 39 weeks with suspected small‑for‑gestational age. The study discusses the merits and limitations of transabdominal, transvaginal, and translabial ultrasound examinations for diagnosing non‑vertex malpresentation. The authors propose using intrapartum translabial scans for documentation, counseling, and education in cases of unusual non‑vertex malpresentation. In this case, intrapartum translabial ultrasound confirmed face presentation and prompted an emergency cesarean delivery for labor dystocia.

Abstract

Abstract We report an unusual case in which sonographic diagnosis of face presentation was made by translabial ultrasound examination during the first stage of labor. In a multigravida, induction of labor was performed at 39 weeks' gestation for suspected small‐for‐gestational age. The diagnosis of face presentation was confirmed by the use of intrapartum translabial ultrasound examination. In face presentation, the orbits and nasal bridge are shown in the center of the presenting part at the mid‐sagittal plane. Emergency cesarean delivery was performed for labor dystocia. Here we discuss the merits and limitations of transabdominal, transvaginal and translabial ultrasound examinations in assisting clinical diagnosis of non‐vertex malpresentation. We propose the use of intrapartum translabial scan in documentation, counseling and education in case of unusual non‐vertex malpresentation.