During face presentation, the attitude of the head will be?

Appeared in: RUHS, Jaipur, M.Sc Nursing Entrance Exam-2019

Explanation

Face presentation is a type of cephalic malpresentation where the fetal head enters the birth canal with the face as the leading part.
The defining attitude for a face presentation is complete extension (hyperextension) of the fetal head.
This hyperextension causes the occiput (back of the head) to touch the fetal back.
As a result of this attitude, the chin (mentum) becomes the designated landmark (denominator) for describing the position.

Option A: Partial extension is the attitude associated with a brow presentation, not a face presentation.
Option B: Deflexion is another term for partial extension, which is characteristic of a brow presentation.
Option D: Flexion is the opposite of extension and is the normal and most common fetal attitude.

Clinical Relevance

Nursing practice connection: This is primarily an exam-oriented knowledge point with limited direct bedside application, so retain Fetal attitude in face presentation as background academic context rather than a clinical decision trigger.
Identifying face presentation is critical for labor management. While vaginal delivery is possible, it depends on the chin's position.
Vaginal delivery can proceed if the chin is anterior (mentum anterior, MA), allowing the head to flex as it passes under the pubic bone. However, if the chin is posterior (mentum posterior, MP), the neck is too short to span the sacrum, preventing delivery and necessitating a cesarean section.
Newborns delivered from a face presentation often have significant facial edema and bruising, which is temporary but can be alarming to parents. The nurse should be prepared to provide reassurance.

How to Approach the Question

First, identify the key terms in the question: 'face presentation' and 'attitude of the head'.
Recall the definition of fetal attitude, which is the relationship of the fetal head to its trunk (the degree of flexion or extension).
Mentally review the different types of cephalic presentations and their corresponding attitudes.
Associate 'vertex presentation' with 'flexion' (the normal attitude).
Associate 'brow presentation' with 'partial extension' or 'deflexion'.
Associate 'face presentation' with 'complete extension' or 'hyperextension'.

Concept Tested & Keywords

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E6 Obstetrics Williams pp. 38-56, 19-36

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Attempt every question from this paper in a timed mock, then review the full solution for each one.