{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2025,9,27]],"date-time":"2025-09-27T00:04:24Z","timestamp":1758931464100,"version":"3.44.0"},"reference-count":23,"publisher":"Frontiers Media SA","license":[{"start":{"date-parts":[[2025,9,26]],"date-time":"2025-09-26T00:00:00Z","timestamp":1758844800000},"content-version":"vor","delay-in-days":0,"URL":"https:\/\/creativecommons.org\/licenses\/by\/4.0\/"}],"content-domain":{"domain":["frontiersin.org"],"crossmark-restriction":true},"short-container-title":["Front. Med."],"abstract":"<jats:p>We report the case of a 40\u202f+\u202f2-week pregnant woman who experienced spontaneous rupture of membranes at the end of the first stage of labor, followed by palpation of an irregular, soft tissue mass at the presenting part. Initial examination suggested a breech presentation; however, a definitive diagnosis could not be established by palpation alone. Using a vaginal dilator to directly visualize the presenting part, we confirmed the diagnosis of face presentation and achieved a successful vaginal delivery, with favorable outcomes for both the mother and the neonate. By reviewing the patient\u2019s medical history, diagnostic process, and delivery progression, we identified the causative factors and underlying delivery mechanism in this case. We propose a simple and practical diagnostic approach and share a novel obstetric technique for fetal spinal protection during delivery. Furthermore, we underscore the importance of multidisciplinary collaboration in the management of facial presentation to optimize maternal and neonatal outcomes, thereby offering a reference for the clinical management of similar cases.<\/jats:p>","DOI":"10.3389\/fmed.2025.1664796","type":"journal-article","created":{"date-parts":[[2025,9,26]],"date-time":"2025-09-26T05:30:47Z","timestamp":1758864647000},"update-policy":"https:\/\/doi.org\/10.3389\/crossmark-policy","source":"Crossref","is-referenced-by-count":0,"title":["Diagnosis and management of face presentation: a case report featuring an innovative diagnostic approach and fetal spinal protection technique"],"prefix":"10.3389","volume":"12","author":[{"given":"Ying","family":"Cui","sequence":"first","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Jingjing","family":"Yi","sequence":"additional","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Birong","family":"Xiao","sequence":"additional","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Chen","family":"Chen","sequence":"additional","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]}],"member":"1965","published-online":{"date-parts":[[2025,9,26]]},"reference":[{"key":"ref1","doi-asserted-by":"publisher","first-page":"540","DOI":"10.1111\/j.1600-0412.2011.01105.x","article-title":"Malpresentations\u2014impact on mode of delivery","volume":"90","author":"Gardberg","year":"2011","journal-title":"Acta Obstet Gynecol Scand"},{"key":"ref2","doi-asserted-by":"publisher","first-page":"923","DOI":"10.1007\/s00404-024-07406-4","article-title":"Face presentation at term: incidence, risk factors and influence on maternal and neonatal outcomes","volume":"310","author":"Zhang","year":"2024","journal-title":"Arch Gynecol Obstet"},{"key":"ref3","doi-asserted-by":"publisher","first-page":"1097","DOI":"10.1016\/0002-9378(73)90943-5","article-title":"Obstetric malpresentations: twenty years\u2019 experience","volume":"116","author":"Cruikshank","year":"1973","journal-title":"Am J Obstet Gynecol"},{"key":"ref4","doi-asserted-by":"publisher","first-page":"246","DOI":"10.1097\/GRF.0000000000000103","article-title":"Management of fetal malpresentation","volume":"58","author":"Sharshiner","year":"2015","journal-title":"Clin Obstet Gynecol"},{"key":"ref5","doi-asserted-by":"publisher","first-page":"333","DOI":"10.1097\/00003081-198106000-00003","article-title":"Face and brow presentation: a review","volume":"24","author":"Cruikshank","year":"1981","journal-title":"Clin Obstet Gynecol"},{"key":"ref6","doi-asserted-by":"publisher","first-page":"633","DOI":"10.1016\/j.ajog.2017.07.025","article-title":"The use of intrapartum ultrasound to diagnose malpositions and cephalic malpresentations","volume":"217","author":"Bellussi","year":"2017","journal-title":"Am J Obstet Gynecol"},{"key":"ref7","doi-asserted-by":"publisher","first-page":"117","DOI":"10.1002\/uog.11077","article-title":"Intrapartum three-dimensional ultrasonographic imaging of face presentations: report of two cases","volume":"40","author":"Ghi","year":"2012","journal-title":"Ultrasound Obstet Gynecol"},{"key":"ref8","doi-asserted-by":"publisher","first-page":"1868","DOI":"10.1111\/j.1447-0756.2011.01650.x","article-title":"Intrapartum translabial ultrasound demonstration of face presentation during first stage of labor","volume":"37","author":"Lau","year":"2011","journal-title":"J Obstet Gynaecol Res"},{"key":"ref9","doi-asserted-by":"publisher","first-page":"e10","DOI":"10.1016\/j.ajog.2005.11.029","article-title":"Face presentation: predictors and delivery route","volume":"194","author":"Shaffer","year":"2006","journal-title":"Am J Obstet Gynecol"},{"key":"ref10","doi-asserted-by":"publisher","first-page":"3248","DOI":"10.1111\/jocn.16438","article-title":"Risk factors for severe perineal lacerations during childbirth: a systematic review and meta-analysis of cohort studies","volume":"32","author":"Hu","year":"2023","journal-title":"J Clin Nurs"},{"key":"ref11","doi-asserted-by":"publisher","first-page":"869","DOI":"10.1007\/s00404-019-05241-6","article-title":"Prognosis for deliveries in face presentation: a case-control study","volume":"300","author":"Ars\u00e8ne","year":"2019","journal-title":"Arch Gynecol Obstet"},{"key":"ref12","doi-asserted-by":"publisher","first-page":"172","DOI":"10.1111\/j.1479-828x.1986.tb01560.x","article-title":"Face presentation","volume":"26","author":"Schwartz","year":"1986","journal-title":"Aust N Z J Obstet Gynaecol"},{"key":"ref13","doi-asserted-by":"publisher","first-page":"1573","DOI":"10.1111\/jog.12369","article-title":"Face presentation at term: a forgotten issue","volume":"40","author":"Tapisiz","year":"2014","journal-title":"J Obstet Gynaecol Res"},{"key":"ref14","doi-asserted-by":"publisher","first-page":"1021","DOI":"10.1097\/AOG.0b013e3181d9f4cd","article-title":"Multidisciplinary team training in a simulation setting for acute obstetric emergencies: a systematic review","volume":"115","author":"Meri\u00e9n","year":"2010","journal-title":"Obstet Gynecol"},{"key":"ref15","doi-asserted-by":"publisher","first-page":"354","DOI":"10.1016\/j.jpag.2019.05.002","article-title":"Vaginal dilator therapy: a guide for providers for assessing readiness and supporting patients through the process successfully","volume":"32","author":"Amies Oelschlager","year":"2019","journal-title":"J Pediatr Adolesc Gynecol"},{"key":"ref16","doi-asserted-by":"publisher","first-page":"479","DOI":"10.1016\/j.prro.2019.07.001","article-title":"Literature review of vaginal stenosis and dilator use in radiation oncology","volume":"9","author":"Damast","year":"2019","journal-title":"Pract Radiat Oncol"},{"key":"ref17","doi-asserted-by":"publisher","first-page":"e28705","DOI":"10.1097\/MD.0000000000028705","article-title":"Vaginal dilator use to promote sexual wellbeing after radiotherapy in gynecological cancer survivors","volume":"101","author":"Charatsi","year":"2022","journal-title":"Medicine"},{"key":"ref18","article-title":"Queensland clinical guidelines: gestational diabetes mellitus (GDM)","year":"2022"},{"key":"ref19","doi-asserted-by":"publisher","first-page":"357","DOI":"10.1080\/14767050802037647","article-title":"Face and brow presentation: independent risk factors","volume":"21","author":"Bashiri","year":"2008","journal-title":"J Matern Fetal Neonatal Med"},{"key":"ref20","doi-asserted-by":"publisher","first-page":"915","DOI":"10.1016\/s0029-7844(03)00068-1","article-title":"Persistent fetal occiput posterior position: obstetric outcomes","volume":"101","author":"Ponkey","year":"2003","journal-title":"Obstet Gynecol"},{"key":"ref21","doi-asserted-by":"publisher","first-page":"79","DOI":"10.1007\/s00381-007-0437-z","article-title":"Birth-related spinal cord injuries: a multicentric review of nine cases","volume":"24","author":"Vialle","year":"2008","journal-title":"Childs Nerv Syst"},{"key":"ref22","first-page":"199","article-title":"Face presentation at term","volume":"55","author":"Benedetti","year":"1980","journal-title":"Obstet Gynecol"},{"key":"ref23","doi-asserted-by":"publisher","first-page":"292","DOI":"10.11604\/pamj.2019.33.292.18927","article-title":"Management of face presentation, face and lip edema in a primary healthcare facility case report, Mbengwi, Cameroon","volume":"33","author":"Fomukong","year":"2019","journal-title":"Pan Afr Med J"}],"container-title":["Frontiers in Medicine"],"original-title":[],"link":[{"URL":"https:\/\/www.frontiersin.org\/articles\/10.3389\/fmed.2025.1664796\/full","content-type":"unspecified","content-version":"vor","intended-application":"similarity-checking"}],"deposited":{"date-parts":[[2025,9,26]],"date-time":"2025-09-26T05:30:48Z","timestamp":1758864648000},"score":1,"resource":{"primary":{"URL":"https:\/\/www.frontiersin.org\/articles\/10.3389\/fmed.2025.1664796\/full"}},"subtitle":[],"short-title":[],"issued":{"date-parts":[[2025,9,26]]},"references-count":23,"alternative-id":["10.3389\/fmed.2025.1664796"],"URL":"https:\/\/doi.org\/10.3389\/fmed.2025.1664796","relation":{},"ISSN":["2296-858X"],"issn-type":[{"value":"2296-858X","type":"electronic"}],"subject":[],"published":{"date-parts":[[2025,9,26]]},"article-number":"1664796"}}