fetal presentation vertex means

Fetal Presentation, Position, and Lie (Including Breech Presentation)

• Variations in Fetal Position and Presentation |

During pregnancy, the fetus can be positioned in many different ways inside the mother's uterus. The fetus may be head up or down or facing the mother's back or front. At first, the fetus can move around easily or shift position as the mother moves. Toward the end of the pregnancy the fetus is larger, has less room to move, and stays in one position. How the fetus is positioned has an important effect on delivery and, for certain positions, a cesarean delivery is necessary. There are medical terms that describe precisely how the fetus is positioned, and identifying the fetal position helps doctors to anticipate potential difficulties during labor and delivery.

Presentation refers to the part of the fetus’s body that leads the way out through the birth canal (called the presenting part). Usually, the head leads the way, but sometimes the buttocks (breech presentation), shoulder, or face leads the way.

Position refers to whether the fetus is facing backward (occiput anterior) or forward (occiput posterior). The occiput is a bone at the back of the baby's head. Therefore, facing backward is called occiput anterior (facing the mother’s back and facing down when the mother lies on her back). Facing forward is called occiput posterior (facing toward the mother's pubic bone and facing up when the mother lies on her back).

Lie refers to the angle of the fetus in relation to the mother and the uterus. Up-and-down (with the baby's spine parallel to mother's spine, called longitudinal) is normal, but sometimes the lie is sideways (transverse) or at an angle (oblique).

For these aspects of fetal positioning, the combination that is the most common, safest, and easiest for the mother to deliver is the following:

Head first (called vertex or cephalic presentation)

Facing backward (occiput anterior position)

Spine parallel to mother's spine (longitudinal lie)

Neck bent forward with chin tucked

Arms folded across the chest

If the fetus is in a different position, lie, or presentation, labor may be more difficult, and a normal vaginal delivery may not be possible.

Variations in fetal presentation, position, or lie may occur when

The fetus is too large for the mother's pelvis (fetopelvic disproportion).

The uterus is abnormally shaped or contains growths such as fibroids .

The fetus has a birth defect .

There is more than one fetus (multiple gestation).

Position and Presentation of the Fetus

Variations in fetal position and presentation.

Some variations in position and presentation that make delivery difficult occur frequently.

Occiput posterior position

In occiput posterior position (sometimes called sunny-side up), the fetus is head first (vertex presentation) but is facing forward (toward the mother's pubic bone—that is, facing up when the mother lies on her back). This is a very common position that is not abnormal, but it makes delivery more difficult than when the fetus is in the occiput anterior position (facing toward the mother's spine—that is facing down when the mother lies on her back).

When a fetus faces up, the neck is often straightened rather than bent,which requires more room for the head to pass through the birth canal. Delivery assisted by a vacuum device or forceps or cesarean delivery may be necessary.

Breech presentation

In breech presentation, the baby's buttocks or sometimes the feet are positioned to deliver first (before the head).

When delivered vaginally, babies that present buttocks first are more at risk of injury or even death than those that present head first.

The reason for the risks to babies in breech presentation is that the baby's hips and buttocks are not as wide as the head. Therefore, when the hips and buttocks pass through the cervix first, the passageway may not be wide enough for the head to pass through. In addition, when the head follows the buttocks, the neck may be bent slightly backwards. The neck being bent backward increases the width required for delivery as compared to when the head is angled forward with the chin tucked, which is the position that is easiest for delivery. Thus, the baby’s body may be delivered and then the head may get caught and not be able to pass through the birth canal. When the baby’s head is caught, this puts pressure on the umbilical cord in the birth canal, so that very little oxygen can reach the baby. Brain damage due to lack of oxygen is more common among breech babies than among those presenting head first.

In a first delivery, these problems may occur more frequently because a woman’s tissues have not been stretched by previous deliveries. Because of risk of injury or even death to the baby, cesarean delivery is preferred when the fetus is in breech presentation, unless the doctor is very experienced with and skilled at delivering breech babies or there is not an adequate facility or equipment to safely perform a cesarean delivery.

Breech presentation is more likely to occur in the following circumstances:

Labor starts too soon (preterm labor).

The uterus is abnormally shaped or contains abnormal growths such as fibroids .

Other presentations

In face presentation, the baby's neck arches back so that the face presents first rather than the top of the head.

In brow presentation, the neck is moderately arched so that the brow presents first.

Usually, fetuses do not stay in a face or brow presentation. These presentations often change to a vertex (top of the head) presentation before or during labor. If they do not, a cesarean delivery is usually recommended.

In transverse lie, the fetus lies horizontally across the birth canal and presents shoulder first. A cesarean delivery is done, unless the fetus is the second in a set of twins. In such a case, the fetus may be turned to be delivered through the vagina.

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• Third Trimester
• Labor & Delivery

What Is Vertex Presentation?

Vertex presentation is just medical speak for “baby’s head-down in the birth canal and rearing to go!” About 97 percent of all deliveries are headfirst, or vertex—and rare is the OB who will try to deliver any other way.

Other, less common presentations include breech (when baby’s head is near your ribs) and transverse (which means the shoulder, arm or trunk is due to come out first because baby is lying on his side). Most babies will turn by about 34 weeks, but some have “unstable lies,” meaning they’re like a politician trying to make everyone happy—that is, they frequently flip positions.

About 95 percent of all babies will be head-down and ready to go by delivery day. If your little one isn’t vertex by 36 weeks, ask your doctor about your options. She may recommend doing a version procedure , in which the doctor tries to manually turn baby by pushing on your abdomen, but it does carry some risks and is only about 60 to 70 percent successful.

Expert: Melissa M. Goist, MD, assistant professor, obstetrics and gynecology, The Ohio State University Medical Center.

Please note: The Bump and the materials and information it contains are not intended to, and do not constitute, medical or other health advice or diagnosis and should not be used as such. You should always consult with a qualified physician or health professional about your specific circumstances.

Plus, more from The Bump:

Delivering a breech baby?

Shift breech baby before birth?

Will my baby be breech?

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Fetal Presentation, Position, and Lie (Including Breech Presentation)

• Key Points |

Abnormal fetal lie or presentation may occur due to fetal size, fetal anomalies, uterine structural abnormalities, multiple gestation, or other factors. Diagnosis is by examination or ultrasonography. Management is with physical maneuvers to reposition the fetus, operative vaginal delivery , or cesarean delivery .

Terms that describe the fetus in relation to the uterus, cervix, and maternal pelvis are

Fetal presentation: Fetal part that overlies the maternal pelvic inlet; vertex (cephalic), face, brow, breech, shoulder, funic (umbilical cord), or compound (more than one part, eg, shoulder and hand)

Fetal position: Relation of the presenting part to an anatomic axis; for transverse presentation, occiput anterior, occiput posterior, occiput transverse

Fetal lie: Relation of the fetus to the long axis of the uterus; longitudinal, oblique, or transverse

Normal fetal lie is longitudinal, normal presentation is vertex, and occiput anterior is the most common position.

Abnormal fetal lie, presentation, or position may occur with

Fetopelvic disproportion (fetus too large for the pelvic inlet)

Fetal congenital anomalies

Uterine structural abnormalities (eg, fibroids, synechiae)

Multiple gestation

Several common types of abnormal lie or presentation are discussed here.

Transverse lie

Fetal position is transverse, with the fetal long axis oblique or perpendicular rather than parallel to the maternal long axis. Transverse lie is often accompanied by shoulder presentation, which requires cesarean delivery.

Breech presentation

There are several types of breech presentation.

Frank breech: The fetal hips are flexed, and the knees extended (pike position).

Complete breech: The fetus seems to be sitting with hips and knees flexed.

Single or double footling presentation: One or both legs are completely extended and present before the buttocks.

Types of breech presentations

Breech presentation makes delivery difficult ,primarily because the presenting part is a poor dilating wedge. Having a poor dilating wedge can lead to incomplete cervical dilation, because the presenting part is narrower than the head that follows. The head, which is the part with the largest diameter, can then be trapped during delivery.

Additionally, the trapped fetal head can compress the umbilical cord if the fetal umbilicus is visible at the introitus, particularly in primiparas whose pelvic tissues have not been dilated by previous deliveries. Umbilical cord compression may cause fetal hypoxemia.

Predisposing factors for breech presentation include

Preterm labor

Uterine abnormalities

Fetal anomalies

If delivery is vaginal, breech presentation may increase risk of

Umbilical cord prolapse

Birth trauma

Perinatal death

Face or brow presentation

In face presentation, the head is hyperextended, and position is designated by the position of the chin (mentum). When the chin is posterior, the head is less likely to rotate and less likely to deliver vaginally, necessitating cesarean delivery.

Brow presentation usually converts spontaneously to vertex or face presentation.

Occiput posterior position

The most common abnormal position is occiput posterior.

The fetal neck is usually somewhat deflexed; thus, a larger diameter of the head must pass through the pelvis.

Progress may arrest in the second phase of labor. Operative vaginal delivery or cesarean delivery is often required.

Position and Presentation of the Fetus

If a fetus is in the occiput posterior position, operative vaginal delivery or cesarean delivery is often required.

In breech presentation, the presenting part is a poor dilating wedge, which can cause the head to be trapped during delivery, often compressing the umbilical cord.

For breech presentation, usually do cesarean delivery at 39 weeks or during labor, but external cephalic version is sometimes successful before labor, usually at 37 or 38 weeks.

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Appointments at Mayo Clinic

• Pregnancy week by week
• Fetal presentation before birth

The way a baby is positioned in the uterus just before birth can have a big effect on labor and delivery. This positioning is called fetal presentation.

Babies twist, stretch and tumble quite a bit during pregnancy. Before labor starts, however, they usually come to rest in a way that allows them to be delivered through the birth canal headfirst. This position is called cephalic presentation. But there are other ways a baby may settle just before labor begins.

Following are some of the possible ways a baby may be positioned at the end of pregnancy.

Head down, face down

When a baby is head down, face down, the medical term for it is the cephalic occiput anterior position. This the most common position for a baby to be born in. With the face down and turned slightly to the side, the smallest part of the baby's head leads the way through the birth canal. It is the easiest way for a baby to be born.

Head down, face up

When a baby is head down, face up, the medical term for it is the cephalic occiput posterior position. In this position, it might be harder for a baby's head to go under the pubic bone during delivery. That can make labor take longer.

Most babies who begin labor in this position eventually turn to be face down. If that doesn't happen, and the second stage of labor is taking a long time, a member of the health care team may reach through the vagina to help the baby turn. This is called manual rotation.

In some cases, a baby can be born in the head-down, face-up position. Use of forceps or a vacuum device to help with delivery is more common when a baby is in this position than in the head-down, face-down position. In some cases, a C-section delivery may be needed.

Frank breech

When a baby's feet or buttocks are in place to come out first during birth, it's called a breech presentation. This happens in about 3% to 4% of babies close to the time of birth. The baby shown below is in a frank breech presentation. That's when the knees aren't bent, and the feet are close to the baby's head. This is the most common type of breech presentation.

If you are more than 36 weeks into your pregnancy and your baby is in a frank breech presentation, your health care professional may try to move the baby into a head-down position. This is done using a procedure called external cephalic version. It involves one or two members of the health care team putting pressure on your belly with their hands to get the baby to roll into a head-down position.

If the procedure isn't successful, or if the baby moves back into a breech position, talk with a member of your health care team about the choices you have for delivery. Most babies in a frank breech position are born by planned C-section.

Complete and incomplete breech

A complete breech presentation, as shown below, is when the baby has both knees bent and both legs pulled close to the body. In an incomplete breech, one or both of the legs are not pulled close to the body, and one or both of the feet or knees are below the baby's buttocks. If a baby is in either of these positions, you might feel kicking in the lower part of your belly.

If you are more than 36 weeks into your pregnancy and your baby is in a complete or incomplete breech presentation, your health care professional may try to move the baby into a head-down position. This is done using a procedure called external cephalic version. It involves one or two members of the health care team putting pressure on your belly with their hands to get the baby to roll into a head-down position.

If the procedure isn't successful, or if the baby moves back into a breech position, talk with a member of your health care team about the choices you have for delivery. Many babies in a complete or incomplete breech position are born by planned C-section.

When a baby is sideways — lying horizontal across the uterus, rather than vertical — it's called a transverse lie. In this position, the baby's back might be:

• Down, with the back facing the birth canal.
• Sideways, with one shoulder pointing toward the birth canal.
• Up, with the hands and feet facing the birth canal.

Although many babies are sideways early in pregnancy, few stay this way when labor begins.

If your baby is in a transverse lie during week 37 of your pregnancy, your health care professional may try to move the baby into a head-down position. This is done using a procedure called external cephalic version. External cephalic version involves one or two members of your health care team putting pressure on your belly with their hands to get the baby to roll into a head-down position.

If the procedure isn't successful, or if the baby moves back into a transverse lie, talk with a member of your health care team about the choices you have for delivery. Many babies who are in a transverse lie are born by C-section.

If you're pregnant with twins and only the twin that's lower in the uterus is head down, as shown below, your health care provider may first deliver that baby vaginally.

Then, in some cases, your health care team may suggest delivering the second twin in the breech position. Or they may try to move the second twin into a head-down position. This is done using a procedure called external cephalic version. External cephalic version involves one or two members of the health care team putting pressure on your belly with their hands to get the baby to roll into a head-down position.

Your health care team may suggest delivery by C-section for the second twin if:

• An attempt to deliver the baby in the breech position is not successful.
• You do not want to try to have the baby delivered vaginally in the breech position.
• An attempt to move the baby into a head-down position is not successful.
• You do not want to try to move the baby to a head-down position.

In some cases, your health care team may advise that you have both twins delivered by C-section. That might happen if the lower twin is not head down, the second twin has low or high birth weight as compared to the first twin, or if preterm labor starts.

• Landon MB, et al., eds. Normal labor and delivery. In: Gabbe's Obstetrics: Normal and Problem Pregnancies. 8th ed. Elsevier; 2021. https://www.clinicalkey.com. Accessed May 19, 2023.
• Holcroft Argani C, et al. Occiput posterior position. https://www.updtodate.com/contents/search. Accessed May 19, 2023.
• Frequently asked questions: If your baby is breech. American College of Obstetricians and Gynecologists https://www.acog.org/womens-health/faqs/if-your-baby-is-breech. Accessed May 22, 2023.
• Hofmeyr GJ. Overview of breech presentation. https://www.updtodate.com/contents/search. Accessed May 22, 2023.
• Strauss RA, et al. Transverse fetal lie. https://www.updtodate.com/contents/search. Accessed May 22, 2023.
• Chasen ST, et al. Twin pregnancy: Labor and delivery. https://www.updtodate.com/contents/search. Accessed May 22, 2023.
• Cohen R, et al. Is vaginal delivery of a breech second twin safe? A comparison between delivery of vertex and non-vertex second twins. The Journal of Maternal-Fetal & Neonatal Medicine. 2021; doi:10.1080/14767058.2021.2005569.
• Marnach ML (expert opinion). Mayo Clinic. May 31, 2023.

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Vertex Position: What It Is, Why It's Important, and How to Get There

Jamie Grill / Getty Images

What Is the Vertex Position?

• Why It's Important

When the Vertex Position Usually Occurs

• How to Get Baby in This Position

Options if Baby Is Not in the Vertex Position

While you are pregnant, you may hear your healthcare provider frequently refer to the position or presentation of your baby, particularly as you get closer to your due date . What they are referring to is which part of your baby is presenting first—or which part is at the lower end of your womb or the pelvic inlet.

Consequently, when they tell you that your baby's head is down, that likely means they are in the vertex position (or another cephalic position). This type of presentation is the most common presentation in the third trimester. Here is what you need to know about the vertex position including how you might get your baby into that position before you go into labor .

The vertex position is a medical term that means the fetus has its head down in the maternal pelvis and the occipital (back) portion of the fetal skull is in the lowest position or presenting, explains Jill Purdie, MD, an OB/GYN and medical director at Northside Women’s Specialists , which is part of Pediatrix Medical Group.

When a baby is in the vertex position, their head is in the down position in the pelvis in preparation for a vaginal birth, adds Shaghayegh DeNoble, MD, FACOG , a board-certified gynecologist and a fellowship-trained minimally invasive gynecologic surgeon. "More specifically, the fetus’s chin is tucked to the chest so that the back of the head is presenting first."

Why the Vertex Position Is Important

When it comes to labor and delivery, the vertex position is the ideal position for a vaginal delivery, especially if the baby is in the occiput anterior position—where the back of the baby's head is toward the front of the pregnant person's pelvis, says Dr. DeNoble.

"[This] is the best position for vaginal birth because it is associated with fewer Cesarean sections , faster births, and less painful births," she says. "In this position, the fetus’s skull fits the birth canal best. In the occiput posterior position, the back of the fetus's head is toward the [pregnant person's] spine. This position is usually associated with longer labor and sometimes more painful birth."

Other fetal positions are sometimes less-than-ideal for labor and delivery. According to Dr. DeNoble, they can cause more prolonged labor, fetal distress, and interventions such as vacuum or forceps delivery and Cesarean delivery.

"Another important fact is that positions other than vertex present an increased risk of cord prolapse, which is when the umbilical cord falls into the vaginal canal ahead of the baby," she says. "For example, if the fetus is in the transverse position and the [pregnant person's] water breaks , there is an increased risk of the umbilical cord prolapsing through the cervix into the vaginal canal."

When it comes to your baby's positioning, obstetricians will look to see what part of the fetus is in position to present during vaginal birth. If your baby’s head is down during labor, they will look to see if the back of the head is facing your front or your back as well as whether the back of the head is presenting or rather face or brow, Dr. DeNoble explains.

"These determinations are important during labor, especially if there is consideration to the use of a vacuum or forceps," she says.

According to Dr. Purdie, healthcare providers will begin assessing the position of the baby as early as 32 to 34 weeks of pregnancy. About 75% to 80% of fetuses will be in the vertex presentation by 30 weeks and 96% to 97% by 37 weeks. Approximately 3% to 4% of fetuses will be in a non-cephalic position at term, she adds.

Typically, your provider will perform what is called Leopold maneuvers to determine the position of the baby. "Leopold maneuvers involve the doctor placing their hands on the gravid abdomen in several locations to find the fetal head and buttocks," Dr. Purdie explains.

If your baby is not in the vertex position, the next most common position would be breech, she says. This means that your baby's legs or buttocks are presenting first and the head is up toward the rib cage.

"The fetus may also be transverse," Dr. Purdie says. "The transverse position means the fetus is sideways within the uterus and no part is presenting in the maternal pelvis. In other words, the head is either on the left or right side of the uterus and the fetus goes straight across to the opposite side."

There is even a chance that your baby will be in an oblique position. This means they are at a diagonal within the uterus, Dr. Purdie says. "In this position, either the head or the buttocks can be down, but they are not in the maternal pelvis and instead off to the left or right side."

If your baby's head is not down, your provider will look to see if the buttocks are in the pelvis or one or two feet, Dr. DeNoble adds. "If the baby is laying horizontally, then the doctor needs to know if the back of the baby is facing downwards or upwards since at a Cesarean delivery it can be more difficult to deliver the baby when the back is down."

How to Get Baby Into the Vertex Position

One way you can help ensure that your baby gets into the vertex position is by staying active and walking, Dr. Purdie says. "Since the head is the heaviest part of the fetus, gravity may help move the head around to the lowest position."

If you already know that your baby is in a non-cephalic position and you are getting close to your delivery date, you also can try some techniques to encourage the baby to turn. For instance, Dr. Purdie suggests getting in the knee/chest position for 10 minutes per day. This has been shown to turn the baby around 60% to 70% of the time.

"In this technique, the mother gets on all fours, places her head down on her hands, and leaves her buttock higher than her head," she explains. "Again, we are trying to allow gravity to help us turn the fetus."

You also might consider visiting a chiropractor to try and help turn the fetus. "Most chiropractors will use the Webster technique to encourage the fetus into a cephalic presentation," Dr. Purdie adds.

There also are some home remedies, including using music, heat, ice, and incense to encourage the fetus to turn, she says. "These techniques do not have a lot of scientific data to support them, but they also are not harmful so can be tried without concern."

You also can try the pelvic tilt , where you lay on your back with your legs bent and your feet on the ground, suggests Dr. DeNoble. Then, you tilt your pelvis up into a bridge position and stay in this position for 10 minutes. She suggests doing this several times a day, ideally when your baby is most active.

"Another technique that has helped some women is to place headphones low down on the abdomen near the pubic bone to encourage the baby to turn toward the sound," Dr. DeNoble adds. "A cold bag of vegetables can be placed at the top of the uterus near the baby’s head and something warm over the lower part of the uterus to encourage the baby to turn toward the warmth. [And] acupuncture has also been used to help turn a baby into a vertex position."

If you are at term and your baby is not in the vertex position (or some type of cephalic presentation), you may want to discuss the option of an external cephalic version (ECV), suggests Dr. Purdie. This is a procedure done in the hospital where your healthcare provider will attempt to manually rotate your baby into the cephalic presentation.

"There are some risks associated with this and not every pregnant person is a candidate, so the details should be discussed with your physician," she says. "If despite interventions, the fetus remains in a non-cephalic position, most physicians will recommend a C-section for delivery."

Keep in mind that there are increased risks for your baby associated with a vaginal breech delivery. Current guidelines by the American College of Obstetricians and Gynecologists recommend a C-section in this situation, Dr. Purdie says.

"Once a pregnant person is in labor, it would be too late for the baby to get in cephalic presentation," she adds.

A Word From Verywell

If your baby is not yet in the vertex position, try not to worry too much. The majority of babies move into either the vertex position or another cephalic presentation before they are born. Until then, focus on staying active, getting plenty of rest, and taking care of yourself.

If you are concerned, talk to your provider about different options for getting your baby to move into the vertex position. They can let you know which tips and techniques might be right for your situation.

American College of Obstetrics and Gynecology. Obstetrics data definitions .

National Library of Medicine. Vaginal delivery .

Sayed Ahmed WA, Hamdy MA. Optimal management of umbilical cord prolapse .  Int J Womens Health . 2018;10:459-465. Published 2018 Aug 21. doi:10.2147/IJWH.S130879

Hjartardóttir H, Lund SH, Benediktsdóttir S, Geirsson RT, Eggebø TM. When does fetal head rotation occur in spontaneous labor at term: results of an ultrasound-based longitudinal study in nulliparous women .  Am J Obstet Gynecol . 2021;224(5):514.e1-514.e9. doi:10.1016/j.ajog.2020.10.054

Management of breech presentation: green-top guideline no. 20b .  BJOG: Int J Obstet Gy . 2017;124(7):e151-e177. doi:10.1111/1471-0528.14465

Kenfack B, Ateudjieu J, Ymele FF, Tebeu PM, Dohbit JS, Mbu RE. Does the advice to assume the knee-chest position at the 36th to 37th weeks of gestation reduce the incidence of breech presentation at delivery?   Clinics in Mother and Child Health . 2012;9:1-5. doi:10.4303/cmch/C120601

Cohain JS. Turning breech babies after 34 weeks: the if, how, & when of turning breech babies .  Midwifery Today Int Midwife . 2007;(83):18-65.

American College of Obstetrics and Gynecology. If your baby is breech .

By Sherri Gordon Sherri Gordon, CLC is a published author, certified professional life coach, and bullying prevention expert. 

Vertex Presentation: How does it affect your labor & delivery?

Medically Reviewed by: Dr. Veena Shinde (M.D, D.G.O,  PG – Assisted Reproductive Technology (ART) from Warick, UK) Mumbai, India

• >> Post Created: February 11, 2022
• >> Last Updated: April 20, 2024

Vertex Position - Table of Contents

As you approach the due date for your baby’s delivery, the excitement and apprehensions are at their peak! What probably adds to the anxieties are the medical terms describing the baby, its ‘position’ and ‘presentation.’ Let’s strike that out from the list now!

In simple words, ‘ position ’ of the baby is always in reference to the mother ; on what side of the mother’s pelvis does the baby lean more (left or right) and if the baby is facing the mother’s spine or belly (anterior or posterior) – for eg.: Left Occiput Anterior , Right Occiput Anterior , Right Occiput Posterior and so on.

On the other hand, ‘ presentation’ is the body part of baby (head, shoulder, feet, and buttocks) that will enter the mother’s pelvic region first at the beginning of labor.

As ‘ presentation’ depends on the ‘ position’ of the baby, the terms cannot be used interchangeably, which is often mistakenly done. If you are told by your doctor that your baby is in a head-down position , which means its head will enter the pelvic region first , then it means the baby is in ‘vertex’ presentation or even sometimes loosely referred to as vertex position of baby though its conceptually incorrect however it means the same.

With this article, we aim to explain how exactly vertex presentation affects your labor and delivery.

Understanding Vertex Presentation

If your baby is in the head-down position by the third trimester, then you are one of the 95% mothers who have a vertex baby or a vertex delivery. When the baby enters the birth canal head first, then the top part of the head is called the ‘vertex.’

In exact medical terms, we give you the definition of vertex presentation by the American College of Obstetrics and Gynecologists (ACOG) – “a fetal presentation where the head is presenting first in the pelvic inlet.”

Besides vertex presentation (also sometimes referred to as vertex position of baby or vertex fetal position also), the other occasional presentations (non-vertex presentations) include –

• Breech – baby’s feet or buttocks are down and first to enter the mother’s pelvic region. Head is near the mother’s ribs
• Transverse – baby’s shoulder, arm or even the trunk are the first to enter the pelvis, as the baby is laying on the side and not in a vertical position 

It is common that babies turn to a particular position (hence, affecting the presentation) by 34 -36 weeks of pregnancy. Nevertheless, some babies have ‘unstable lies’ ; – wherein the baby keeps changing positions towards the end of the pregnancy and not remaining in any one position for long.

Should you be worried if the baby is in vertex presentation?

Absolutely not! The vertex presentation is not only the most common, but also the best for a smooth delivery. In fact, the chances of a vaginal delivery are better if you have a vertex fetal position.

By 36 weeks into pregnancy, about 95% of the babies position themselves to have the vertex presentation. However, if your baby hasn’t come into the vertex fetal position by this time, then you can talk to your doctor about the options.

You may be suggested a cephalic version procedure   also known as the version procedure /external cephalic version (ECV procedure) – which is used to turn the baby/ fetus from a malpresentation – like breech, oblique or transverse (which occur just about 3-4% times) to the cephalic position (head down).

This is how your doctor will try to turn your baby manually by pushing on your belly to get the baby into the vertex presentation. But it is necessary for you to know that this procedure does involve some risk and is successful only 60-70% of the time.

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Risks of vertex position of baby: can there be any complications for the baby in the vertex presentation.

As discussed above, the vertex fetal position/presentation is the best for labor and delivery, but there can be some complications as the baby makes its way through the birth canal. One such complication can arise if the baby is on the larger side. The baby can face difficulty while passing through the birth canal even if it is in the head-down position because of the size.

Babies who weigh over 9 to 10 pounds are called ‘ macrosomic’ or even referred to as fetal macrosomia , and they are at a higher risk of getting their shoulders stuck in the birth canal during delivery, despite being in the head-down position.

In such cases, to avoid birth trauma for the baby, the American College of Obstetricians and Gynecologists (ACOG) suggests that cesarean deliveries should be limited to estimated fetal weights of at least 11 pounds in women without diabetes and about 9 pounds in women with diabetes.

In case of fetal macrosomia, your doctor will monitor your pregnancy more often and work out a particular birth plan for you subject to your age (mothers age) and size of your baby.

How will I deliver a baby in the vertex fetal position?

Even unborn human babies can astonish you if you observe the way they make their way through the birth canal during delivery.

A vertex baby may be in the optimal position ( head-down first in pelvis) for labor and delivery, but it does its own twisting and turning while passing through the birth canal to fit through. In humans, unlike other mammals, the ratio of the baby’s head to the space in the birth canal is quite limited.

The baby has to flex and turn its head in different positions to fit through and ultimately arrive in this world. And it does so successfully! It is a wonder how they know how to do this so naturally.

And to answer the question ‘how will I deliver a baby in the vertex position?’ – Simply NATURALLY i.e. vaginal delivery. Don’t worry, follow your doctor’s instructions, do your breathing and PUSH.

FAQs to keep ready: How can my doctor help me prepare as I approach my due date?

As your due date nears, apart from bodily discomfort, you may experience nervousness about the big day. Your doctor can help by clearing your doubts and putting you at ease. You can ask them the following questions to understand the process better.

Q1) How will I know if my baby is in vertex fetal position?

A doctor can confidently tell you whether or not your baby is in the vertex presentation. Many medical professionals will be able to determine your baby’s position merely by using their hands; this is called ‘Leopold’s maneuvers.’

However, in case they aren’t very confident about the baby’s position even after this, then an ultrasound can confirm the exact position of the baby.

You can also understand this through belly mapping . You are sure to feel the kicks towards the top of your stomach and head (distinct hard circular feel) towards your pelvis. 

Q2)Is there any risk of my vertex baby turning and changing positions?

Yes, in case of some women, the baby who has a vertex presentation may turn at the last moment.

What may cause this? Women who have extra amniotic fluid (polyhydramnios) have increased chances of a vertex baby turning into a breech baby at the last minute.

Discuss this with your doctor to understand what are the chances this might happen to you and what all you can do to keep the baby in the vertex presentation for delivery.

Q3) Is there need to be worried if my baby has a breech presentation?

Not really! There are loads of exercises which you which can help you get your baby in the right position.

Then there are the ECV (external cephalic version) procedure which can help in changing the position of your baby into the desired vertex position. Speak with your doctor.

Having a baby in breech position just before labor will require you to have a C-section . Let your doctor guide you. But there is nothing to worry about.

Q4) What may cause babies to come into breech position?

A few circumstances may cause the baby to come into breech position even after 36 weeks into pregnancy.

• If you are carrying twins or multiple babies , in which case there is limited space for each baby to move around.
• Low levels of amniotic fluid which restricts the free movement of the baby or even high levels of amniotic fluid that does not permit the baby to remain in any one position.
• If there are abnormalities in the uterus or other conditions like low-lying placenta or large fibroids in the lower part of the uterus.

Chances of breech babies are higher in births that are pre-term as the baby does not get enough time to flip into a head-down position – cephalic position – vertex presentation (vertex position of baby/ vertex fetal position).

Q5) Can a baby turn from breech position to vertex presentation?

Yes, a baby can turn from a breech position to vertex position / vertex fetal position over time with exercises and sometimes through ECV.

If an ultrasound has confirmed you have a breech baby, then you can do the following to turn it to a vertex baby. Try the following –

• Do not underestimate the wonders of daily walks of about 45-60 mins when it comes to bringing your baby in vertex presentation from breech presentation.
• Talk to your doctor about certain exercises that can help turn your baby in the head-down position. Exercises like ‘ high bridge’ or ‘cat and camel’ can help here. We recommend you to learn and try this only in the presence of a professional.
• External Cephalic Version (ECV ) is a way to manually maneuver the baby to vertex presentation. It is done with the help of an ultrasound and generally after 36 weeks into pregnancy. However, it has the success rate of just 50%. Discuss the risks, if any, with your gynecologist before opting for this procedure.

There are a couple of other unscientific methods that may not be safe to try –

• Light : Placing a torch near your vagina may guide the baby toward the light, and hence, get it in the vertex presentation.
• Music : Playing music near your belly’s bottom may urge the baby to move itself in the head-down position.

Q6) What all can I do to ensure I have a healthy delivery?

A healthy delivery requires the mother to be active, eating well, and staying happy. For any apprehensions regarding labor and delivery, do not hesitate to talk to your doctor and clarify your doubts.

Your doctor can help you understand your baby’s position and presentation, and then based on that they can plan your delivery to ensure your baby’s birth will happen in the safest possible way.

Try and maintain a healthy lifestyle which will also help in overall of your child and placenta health .

Key Takeaway

Yes, vertex presentation or vertex position of baby and vertex delivery are very common, normal, safe, and the best for labor and delivery of the baby. There is probability of complications sometimes, but that is only subject to certain conditions that we discussed above.

However, understand that any other baby position is also safe. The only thing with other positions and presentations is that the chances of a cesarean delivery goes up. Nevertheless, know what matters at the end of it all is a happy and healthy baby in your arms!

Happy pregnancy!

Khushboo Kirale

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What Your Baby’s Fetal Position Could Mean for Their Birth

As you draw near the end of the third trimester, your baby’s position will begin to take root—and possibly reshape your delivery plans.

Over the past few months, you’ve felt your acrobatic bundle twist, flip, and tumble inside you, but around 32-36 weeks of pregnancy, your babe will settle into a position to get ready for their grand entrance. Usually, babies will be head down—but not always! Knowing your baby’s position will help you be better prepared for labor day possibilities. Here are the phrases that your doctor might use to describe fetal presentation in the womb.

Vertex (or Cephalic) Presentation

Baby’s head is going to be pushed out first, but there are more specific terms depending on which way they’re facing. The vertex presentations are further classified according to the position of the occiput (the back of baby’s head or skull), including right, left, transverse, anterior, or posterior.

Occiput Anterior (AKA Facing Downward)

Baby is headfirst and the back of the head is against your belly . Usually, the head will be turned slightly, so your medical care provider might add a “left” or “right” to the phrase: left occiput-anterior position (LOA); right occiput-anterior position (ROA). This is the most common and preferred position for a vaginal birth.

Occiput Posterior (AKA Facing Upward)

Baby is headfirst and the back of their head is closest to your back . This is another instance where your doctor can specify “left” or “right” in describing whether baby’s face is turned: left occiput-posterior position (LOP); right occiput-posterior position (ROP).

Occiput Transverse (AKA Facing Sideways)

Baby is headfirst and facing toward either side of the birthing parent’s side , halfway between a posterior and anterior position. If facing the left thigh, baby is said to be in the right occiput-transverse position (ROT); when facing the right thigh, baby is in the left occiput-transverse position (LOT).

Your babe’s head is near the top of the uterus , their rear end is facing the birth canal, and their tiny toes are pointing skyward. A breech baby will often change position and turn head-down by 36 weeks. It’s possible to birth vaginally, but a cesarean section (C-section) is usually recommended.

Complete Breech Presentation

This presentation is the same as standard breech, except baby’s legs will be bent at the knees with their feet tucked down near their bottom.

Frank Breech

Baby’s legs are folded flat against their head , and their rear is closest to the birth canal. This is the most common type of breech position.

Transverse Lie

What it means: Your wee one is lying sideways, horizontally across your uterus . Their back or their hands and feet will be nearest to the birth canal, depending on which way they’re facing. While this position is uncommon, a baby in the transverse lie position will not fit into the vaginal canal, making a safe vaginal delivery unlikely, if not impossible. Your OB-GYN will likely recommend a C-section. 

Thankfully, most babies will turn themselves into the correct position for labor. If not, your doctor might suggest an external cephalic version to help manually rotate the baby from the outside using strategic pressure on the baby’s head and bottom. It sounds scary, but complications are rare. A C-section may be needed if your bambino is still transverse as their delivery day approaches.

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Delivery, Face Presentation, and Brow Presentation: Understanding Fetal Positions and Birth Scenarios

Introduction:.

During childbirth, the position of the baby plays a significant role in the delivery process. While the most common fetal presentation is the head-down position (vertex presentation), variations can occur, such as face presentation and brow presentation. This comprehensive article aims to provide a thorough understanding of delivery, face presentation, and brow presentation, including their definitions, causes, complications, and management approaches.

Delivery Process:

• Normal Vertex Presentation: In a typical delivery, the baby is positioned head-down, with the back of the head (occiput) leading the way through the birth canal.
• Engagement and Descent: Prior to delivery, the baby's head engages in the pelvis and gradually descends, preparing for birth.
• Cardinal Movements: The baby undergoes a series of cardinal movements, including flexion, internal rotation, extension, external rotation, and restitution, which facilitate the passage through the birth canal.

Face Presentation:

• Definition: Face presentation occurs when the baby's face is positioned to lead the way through the birth canal instead of the vertex (head).
• Causes: Face presentation can occur due to factors such as abnormal fetal positioning, multiple pregnancies, uterine abnormalities, or maternal pelvic anatomy.
• Complications: Face presentation is associated with an increased risk of prolonged labor, difficulties in delivery, increased fetal malposition, birth injuries, and the need for instrumental delivery.
• Management: The management of face presentation depends on several factors, including the progression of labor, the size of the baby, and the expertise of the healthcare provider. Options may include closely monitoring the progress of labor, attempting a vaginal delivery with careful maneuvers, or considering a cesarean section if complications arise.

Brow Presentation:

• Definition: Brow presentation occurs when the baby's head is partially extended, causing the brow (forehead) to lead the way through the birth canal.
• Causes: Brow presentation may result from abnormal fetal positioning, poor engagement of the fetal head, or other factors that prevent full flexion or extension.
• Complications: Brow presentation is associated with a higher risk of prolonged labor, difficulty in descent, increased chances of fetal head entrapment, birth injuries, and the potential need for instrumental delivery or cesarean section.
• Management: The management of brow presentation depends on various factors, such as cervical dilation, progress of labor, fetal size, and the presence of complications. Close monitoring, expert assessment, and a multidisciplinary approach may be necessary to determine the safest delivery method, which can include vaginal delivery with careful maneuvers, instrumental assistance, or cesarean section if warranted.

Delivery Techniques and Intervention:

• Obstetric Maneuvers: In certain situations, skilled healthcare providers may use obstetric maneuvers, such as manual rotation or the use of forceps or vacuum extraction, to facilitate delivery, reposition the baby, or prevent complications.
• Cesarean Section: In cases where vaginal delivery is not possible or poses risks to the mother or baby, a cesarean section may be performed to ensure a safe delivery.

Conclusion:

Delivery, face presentation, and brow presentation are important aspects of childbirth that require careful management and consideration. Understanding the definitions, causes, complications, and appropriate management approaches associated with these fetal positions can help healthcare providers ensure safe and successful deliveries. Individualized care, close monitoring, and multidisciplinary collaboration are crucial in optimizing maternal and fetal outcomes during these unique delivery scenarios.

Hashtags: #Delivery #FacePresentation #BrowPresentation #Childbirth #ObstetricDelivery

On the Article

Krish Tangella MD, MBA

Alexander Enabnit

Alexandra Warren

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How your twins’ fetal positions affect labor and delivery

Twin fetal presentation – also known as the position of your babies in the womb – dictates whether you'll have a vaginal or c-section birth. Toward the end of pregnancy, most twins will move in the head-down position (vertex), but there's a risk that the second twin will change position after the first twin is born. While there are options to change the second twin's position, this can increase the risk of c-section and other health issues. Learn about the six possible twin fetal presentations: vertex-vertex, vertex-breech, breech-breech, vertex-transverse, breech-transverse, and transverse-transverse – and how they'll impact your delivery and risks for complications.

What is fetal presentation and what does it mean for your twins?

As your due date approaches, you might be wondering how your twins are currently positioned in the womb, also known as the fetal presentation, and what that means for your delivery. Throughout your pregnancy, your twin babies will move in the uterus, but sometime during the third trimester – usually between 32 and 36 weeks – their fetal presentation changes as they prepare to go down the birth canal.

The good news is that at most twin births, both babies are head-down (vertex), which means you can have a vaginal delivery. In fact, nearly 40 percent of twins are delivered vaginally.

But if one baby has feet or bottom first (breech) or is sideways (transverse), your doctor might deliver the lower twin vaginally and then try to rotate the other twin so that they face head-down (also called external cephalic version or internal podalic version) and can be delivered vaginally. But if that doesn't work, there's still a chance that your doctor will be able to deliver the second twin feet first vaginally via breech extraction (delivering the breech baby feet or butt first through the vagina).

That said, a breech extraction depends on a variety of factors – including how experienced your doctor is in the procedure and how much the second twin weighs. Studies show that the higher rate of vaginal births among nonvertex second twins is associated with labor induction and more experienced doctors, suggesting that proper delivery planning may increase your chances of a vaginal birth .

That said, you shouldn't totally rule out a Cesarean delivery with twins . If the first twin is breech or neither of the twins are head-down, then you'll most likely have a Cesarean delivery.

Research also shows that twin babies who are born at less than 34 weeks and have moms with multiple children are associated with intrapartum presentation change (when the fetal presentation of the second twin changes from head-down to feet first after the delivery of the first twin) of the second twin. Women who have intrapartum presentation change are more likely to undergo a Cesarean delivery for their second twin.

Here's a breakdown of the different fetal presentations for twin births and how they will affect your delivery.

Head down, head down (vertex, vertex)

This fetal presentation is the most promising for a vaginal delivery because both twins are head-down. Twins can change positions, but if they're head-down at 28 weeks, they're likely to stay that way.

When delivering twins vaginally, there is a risk that the second twin will change position after the delivery of the first. Research shows that second twins change positions in 20 percent of planned vaginal deliveries. If this happens, your doctor may try to rotate the second twin so it faces head-down or consider a breech extraction. But if neither of these work or are an option, then a Cesarean delivery is likely.

In vertex-vertex pairs, the rate of Cesarean delivery for the second twin after a vaginal delivery of the first one is 16.9 percent.

Like all vaginal deliveries, there's also a chance you'll have an assisted birth, where forceps or a vacuum are needed to help deliver your twins.

Head down, bottom down (vertex, breech)

When the first twin's (the lower one) head is down, but the second twin isn't, your doctor may attempt a vaginal delivery by changing the baby's position or doing breech extraction, which isn't possible if the second twin weighs much more than the first twin.

The rates of emergency C-section deliveries for the second twin after a vaginal delivery of the first twin are higher in second twins who have a very low birth weight. Small babies may not tolerate labor as well.

Head down, sideways (vertex, transverse)

If one twin is lying sideways or diagonally (oblique), there's a chance the baby may shift position as your labor progresses, or your doctor may try to turn the baby head-down via external cephalic version or internal podalic version (changing position in the uterus), which means you may be able to deliver both vaginally.

Bottom down, bottom down (breech, breech)

When both twins are breech, a planned C-section is recommended because your doctor isn't able to turn the fetuses. Studies also show that there are fewer negative neonatal outcomes for planned C-sections than planned vaginal births in breech babies.

As with any C-section, the risks for a planned one with twins include infection, loss of blood, blood clots, injury to the bowel or bladder, a weak uterine wall, placenta abnormalities in future pregnancies and fetal injury.

Bottom down, sideways (breech, transverse)

When the twin lowest in your uterus is breech or transverse (which happens in 25 percent of cases), you'll need to have a c-section.

Sideways, sideways (transverse, transverse)

This fetal presentation is rare with less than 1 percent of cases. If both babies are lying horizontally, you'll almost definitely have a C-section.

Learn more:

• Twin fetal development month by month
• Your likelihood of having twins or more
• When and how to find out if you’re carrying twins or more

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BabyCenter's editorial team is committed to providing the most helpful and trustworthy pregnancy and parenting information in the world. When creating and updating content, we rely on credible sources: respected health organizations, professional groups of doctors and other experts, and published studies in peer-reviewed journals. We believe you should always know the source of the information you're seeing. Learn more about our editorial and medical review policies .

Cleveland Clinic. Fetal Positions for Birth: https://my.clevelandclinic.org/health/articles/9677-fetal-positions-for-birth Opens a new window [Accessed July 2021]

Mayo Clinic. Fetal Presentation Before Birth: https://www.mayoclinic.org/healthy-lifestyle/pregnancy-week-by-week/multimedia/fetal-positions/sls-20076615?s=7 Opens a new window [Accessed July 2021]

NHS. Giving Birth to Twins or More: https://pubmed.ncbi.nlm.nih.gov/29016498/ Opens a new window [Accessed July 2021]

Science Direct. Breech Extraction: https://www.sciencedirect.com/topics/medicine-and-dentistry/breech-extraction Opens a new window [Accessed July 2021]

Obstetrics & Gynecology. Clinical Factors Associated With Presentation Change of the Second Twin After Vaginal Delivery of the First Twin https://pubmed.ncbi.nlm.nih.gov/29016498/ Opens a new window [Accessed July 2021]

American Journal of Obstetrics and Gynecology. Fetal presentation and successful twin vaginal delivery: https://www.ajog.org/article/S0002-9378(04)00482-X/fulltext [Accessed July 2021]

The Journal of Maternal-Fetal & Neonatal Medicine. Changes in fetal presentation in twin pregnancies https://www.tandfonline.com/doi/abs/10.1080/14767050400028592 Opens a new window [Accessed July 2021]

Reviews in Obstetrics & Gynecology. An Evidence-Based Approach to Determining Route of Delivery for Twin Gestations https://www.ncbi.nlm.nih.gov/pmc/articles/PMC3252881/ Opens a new window [Accessed July 2021]

Nature. Neonatal mortality and morbidity in vertex–vertex second twins according to mode of delivery and birth weight: https://www.nature.com/articles/7211408 Opens a new window [Accessed July 2021]

Cochrane. Planned cesarean for a twin pregnancy: https://www.cochrane.org/CD006553/PREG_planned-caesarean-section-twin-pregnancy Opens a new window [Accessed July 2021]

Kids Health. What Is the Apgar Score?: https://www.kidshealth.org/Nemours/en/parents/apgar0.html Opens a new window [Accessed July 2021]

American Journal of Obstetrics & Gynecology. Neonatal mortality in second twin according to cause of death, gestational age, and mode of delivery https://pubmed.ncbi.nlm.nih.gov/15467540/ Opens a new window [Accessed July 2021]

Lancet. Planned cesarean section versus planned vaginal birth for breech presentation at term: a randomised multicentre trial. Term Breech Trial Collaborative Group https://pubmed.ncbi.nlm.nih.gov/11052579/ Opens a new window [Accessed July 2021]

Cleveland Clinic. Cesarean Birth (C-Section): https://my.clevelandclinic.org/health/treatments/7246-cesarean-birth-c-section Opens a new window [Accessed July 2021]

St. Jude Medical Staff. Delivery of Twin Gestation: http://www.sjmedstaff.org/documents/Delivery-of-twins.pdf Opens a new window [Accessed July 2021]

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Abnormal Fetal lie, Malpresentation and Malposition

Original Author(s): Anna Mcclune Last updated: 1st December 2018 Revisions: 12

• 1 Definitions
• 2 Risk Factors
• 3.2 Presentation
• 3.3 Position
• 4 Investigations
• 5.1 Abnormal Fetal Lie
• 5.2 Malpresentation
• 5.3 Malposition

The lie, presentation and position of a fetus are important during labour and delivery.

In this article, we will look at the risk factors, examination and management of abnormal fetal lie, malpresentation and malposition.

Definitions

• Longitudinal, transverse or oblique
• Cephalic vertex presentation is the most common and is considered the safest
• Other presentations include breech, shoulder, face and brow
• Usually the fetal head engages in the occipito-anterior position (the fetal occiput facing anteriorly) – this is ideal for birth
• Other positions include occipito-posterior and occipito-transverse.

Note: Breech presentation is the most common malpresentation, and is covered in detail here .

Fig 1 – The two most common fetal presentations: cephalic and breech.

Risk Factors

The risk factors for abnormal fetal lie, malpresentation and malposition include:

• Multiple pregnancy
• Uterine abnormalities (e.g fibroids, partial septate uterus)
• Fetal abnormalities
• Placenta praevia
• Primiparity

Identifying Fetal Lie, Presentation and Position

The fetal lie and presentation can usually be identified via abdominal examination. The fetal position is ascertained by vaginal examination.

For more information on the obstetric examination, see here .

• Face the patient’s head
• Place your hands on either side of the uterus and gently apply pressure; one side will feel fuller and firmer – this is the back, and fetal limbs may feel ‘knobbly’ on the opposite side

Presentation

• Palpate the lower uterus (above the symphysis pubis) with the fingers of both hands; the head feels hard and round (cephalic) and the bottom feels soft and triangular (breech)
• You may be able to gently push the fetal head from side to side

The fetal lie and presentation may not be possible to identify if the mother has a high BMI, if she has not emptied her bladder, if the fetus is small or if there is polyhydramnios .

During labour, vaginal examination is used to assess the position of the fetal head (in a cephalic vertex presentation). The landmarks of the fetal head, including the anterior and posterior fontanelles, indicate the position.

Fig 2 – Assessing fetal lie and presentation.

Investigations

Any suspected abnormal fetal lie or malpresentation should be confirmed by an ultrasound scan . This could also demonstrate predisposing uterine or fetal abnormalities.

Abnormal Fetal Lie

If the fetal lie is abnormal, an external cephalic version (ECV) can be attempted – ideally between 36 and 38 weeks gestation.

ECV is the manipulation of the fetus to a cephalic presentation through the maternal abdomen.

It has an approximate success rate of 50% in primiparous women and 60% in multiparous women. Only 8% of breech presentations will spontaneously revert to cephalic in primiparous women over 36 weeks gestation.

Complications of ECV are rare but include fetal distress , premature rupture of membranes, antepartum haemorrhage (APH) and placental abruption. The risk of an emergency caesarean section (C-section) within 24 hours is around 1 in 200.

ECV is contraindicated in women with a recent APH, ruptured membranes, uterine abnormalities or a previous C-section .

Fig 3 – External cephalic version.

Malpresentation

The management of malpresentation is dependent on the presentation.

• Breech – attempt ECV before labour, vaginal breech delivery or C-section
• Brow – a C-section is necessary
• If the chin is anterior (mento-anterior) a normal labour is possible; however, it is likely to be prolonged and there is an increased risk of a C-section being required
• If the chin is posterior (mento-posterior) then a C-section is necessary
• Shoulder – a C-section is necessary

Malposition

90% of malpositions spontaneously rotate to occipito-anterior as labour progresses. If the fetal head does not rotate, rotation and operative vaginal delivery can be attempted. Alternatively a C-section can be performed.

• Usually the fetal head engages in the occipito-anterior position (the fetal occiput facing anteriorly) - this is ideal for birth

If the fetal lie is abnormal, an external cephalic version (ECV) can be attempted - ideally between 36 and 38 weeks gestation.

• Breech - attempt ECV before labour, vaginal breech delivery or C-section

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vertex presentation

Medical Definition of vertex presentation

Dictionary entries near vertex presentation, cite this entry.

“Vertex presentation.” Merriam-Webster.com Medical Dictionary , Merriam-Webster, https://www.merriam-webster.com/medical/vertex%20presentation. Accessed 20 Apr. 2024.

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• Vertex presentation

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