Compound Presentation

Compound presentation occurs when the part of the fetus closest to the birth canal (usually the head) presents with an extremity next to it (usually hand or arm) (1). This condition is extremely rare; it’s estimated to affect less than 0.004% of pregnancies.

What causes compound presentation?

Compound presentation can occur as a result of (1):

The fetal limb becoming trapped below the fetal head
The fetus not fully occupying the pelvis for some reason, possibly because it is:
- Small for gestational age
- The pelvis is large for fetal size
- The patient presents with polyhydramnios
- The fetus is premature
- There are multiple babies
Membranes that ruptured while the fetus is still high (premature rupture of membranes), which can allow amniotic fluid to push a limb down before the head
In the case of multiples, a head of one baby exiting alongside of the other baby’s limb

Diagnosing compound presentation

It’s possible to discover compound presentation on an ultrasound examination before delivery. Right before or during delivery, it may be diagnosed when an irregular form is found next to or in advance of the head or breech during a pelvic exam.

The doctor can confirm compound presentation with either physical examination or ultrasound examination. It is possible for a transverse lie or breech presentation to be misdiagnosed as a compound presentation involving the foot and head. This may require an ultrasound or digital examination to confirm.

Treating compound presentation

Because compound presentation is such a rare finding and its management depends a great deal on patient-specific circumstances, there isn’t much data available to guide general management of the condition.

It is possible that the baby could reposition as labor continues. Commonly, the extremity will retract during labor.

But it is also likely that compound presentation will result in dystocia and arrested labor. If compound presentation does not resolve with gentle pressure or on its own, baby should be promptly delivered via C-section (1).

Birth complications associated with compound presentation

Arrested labor
Dystocia
Cord prolapse
Injury to the presenting extremity

About ABC Law Centers: Birth Injury Lawyers

ABC Law Centers was established in 1997 to focus exclusively on birth injury cases. If your child’s birth injury could have been prevented with proper care, then it constitutes medical malpractice. Settlements from birth injury lawsuits can cover the costs of lifelong treatments, adaptive technologies, and other crucial resources.

If you believe you may have a birth injury case, contact us today for a free consultation. We’re available 24/7 to listen and answer questions. Don’t worry about the cost – our clients pay nothing throughout the entire legal process until we win!

Disclaimer: ABC Law Centers: Birth Injury Lawyers is not run by medical professionals or associated with a medical facility. The above information should not be taken as medical advice. Always contact a medical professional when you are experiencing any of the above symptoms or any other concerning symptoms during pregnancy.

Related resources

Sources

Barth, W. H., Jr. (2023, July 26). Compound fetal presentation. Retrieved June 7, 2024, from https://www.uptodate.com/contents/compound-fetal-presentation?search=compound
Kesavan, M. (2018, August 1). Management of Brow, Face, and Compound Malpresentations. Retrieved July 7, 2024, from https://exxcellence.org/pearls-of-exxcellence/list-of-pearls/management-of-brow-face-and-compound-malpresentations/