Compound fetal presentation
- William H Barth, Jr, MD
William H Barth, Jr, MD
- Associate Professor
- Harvard Medical School
Compound presentation is a fetal presentation in which an extremity presents alongside the part of the fetus closest to the birth canal. The majority of compound presentations consist of a fetal hand or arm presenting with the vertex . This topic will review the pathogenesis, clinical manifestations, diagnosis, and management of this uncommon intrapartum problem.
Compound presentation complicates from 1 in 268 to 1 in 1000 deliveries [2,3].
PATHOGENESIS AND RISK FACTORS
A variety of clinical settings can lead to compound presentation via different pathways.
●A fetal extremity has room to descend when the fetus does not fully occupy the pelvis because of prematurity, multiple gestation, polyhydramnios, or a large maternal pelvis relative to fetal size [2,3].
●Flow of amniotic fluid after rupture of membranes when the presenting part is still high can carry a fetal extremity, umbilical cord, or both toward the birth canal.
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