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Compound fetal presentation

William H Barth, Jr, MD
Section Editor
Vincenzo Berghella, MD
Deputy Editor
Vanessa A Barss, MD, FACOG


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 [1]. 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].


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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Literature review current through: Oct 2017. | This topic last updated: Nov 29, 2016.
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