Brow Presentation and Birth Injury Complications

Newborn child seconds and minutes after birth. Check upIn ideal vaginal birthing, infants come out in what we call the vertex position. In vertex, the infant goes out head-first, with the chin tucked to the chest. The brow presentation is among the numerous abnormal fetal birthing positions.

When your child is in a brow presentation, it is a dangerous position that can result in birth injuries. The labor complications that come with this position can put your child to danger. What does this mean for you and your baby? Let’s find out.

What is a Brow Presentation?

For babies in a brow presentation, the fetal head goes untucked, in between full flexion and hyperextension vertically. The presenting portion of the head is between the browbone and the crown of the baby’s head. This happens to one baby for every 500 to 1400 deliveries, which makes it very uncommon.

Several factors can lead to children going into brow presentation, which includes:

The brow presentation is a dangerous position for the baby for many reasons. If medical professionals fail to diagnose the issue early on, it can cause lasting consequences. This position offers very little oxygen from extended labor. It can also cause traumatic injuries to both parent and child.

Any medical neglect in finding out the existence of this position can lead to birth defects. These include:

  • Neonatal hypoxic ischemic encephalopathy (HIE)
  • Seizure and other CNS disorders
  • Cerebral palsy
  • Developmental disabilities
  • Tracheal and laryngeal edema

Any of these issues can be a problem in the long run but will mostly come from physician neglect and mismanagement.

Diagnosing Brow Presentation in Labor

Brow presentation is easy to diagnose through a simple vaginal examination during the labor period. Another way to diagnose the presentation is through the use of abdominal palpation by Leopold’s maneuvers. This diagnosis, however, needs confirmation with a dilated cervix.

If the doctor thinks there are no significant findings, the next order of business is ultrasound. There are warning signs that can help a doctor detect brow presentation. Most of the facial features, like the eyes, nose, and chin, are palpable, with ultrasound showing a hyperextended neck.

Managing Brow Presentation

Infants that assume brow presentation can eventually go into more ideal positions late into the delivery process. There are cases where safe delivery is possible in brow presentation, especially if the child is small. If the mother’s cervix is unusually wide, this also presents a way of delivery with this presentation.

If attempting vaginal delivery, doctors need to look out for any signs of fetal distress. Changes in heart rate like tachycardia, bradycardia, or abrupt changes in heart rate signify fetal distress. The physician needs to monitor the progression of labor. Any mistakes at this point can lead to birth injuries for the child.

Prolonged labor can lead to birth asphyxia or fetal oxygen deprivation, which can lead to permanent congenital injuries. Any fetal distress can mean that the baby is in danger of sustaining brain injuries. Doctors need to take action at the first sign of distress.

Converting Brow Presentation and Mitigating Dangers

Attempts to convert brow presentation to vertex by manual means is dangerous. These methods are associated with high levels of fetal morbidity, fetal mortality, and maternal morbidity. The availability and safety of cesarean deliveries make these methods unjustified.

Operative delivery with forceps is a dangerous method and should only happen in specific situations. An increase in potential complications for the mother and child can occur during operative delivery with forceps. The physician should avoid the hyperextension of the fetal head at all costs.

Expectant management is reasonable if the labor’s progress is smooth, and the well-being of the baby undergoes proper assessment. Spontaneous conversion from brow to vertex presentation is possible at any moment. Decision-making should happen as soon as possible, and the parents should receive education in the matter.

The earlier in labor that the doctor can diagnose the brow presentation, the better the chances of correction. Prolonged, dysfunctional, and arrested labor should necessitate cesarean delivery.

Getting Compensation as a Result of Brow Presentation and Medical Malpractice

During delivery, the mother and medical guardians must know the situation. Informed consent is paramount during labor and delivery. They should know the risks and health options available so they can decide on the course of action.

If your child is in brow presentation and you or your child received lasting damage, this is medical malpractice. Talk to a personal injury lawyer today on how you can get the right compensation and bring justice for you and your child.


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