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https://emedicine.medscape.com/article/262444-overview
Jan 24, 2019 · Compound presentations are rare obstetric events and often engender much anxiety in the care team. Such concerns are usually unjustified, but considering the unlikely possibility of a problem delivery is valuable.
https://www.uptodate.com/contents/compound-fetal-presentation
Compound presentation is a fetal presentation in which an extremity presents alongside the part of the fetus closest to the birth canal. The majority of compound presentations consist of a fetal hand or arm presenting with the head . This topic will review the pathogenesis, clinical manifestations, diagnosis, and management of this uncommon intrapartum problem.
https://www.abclawcenters.com/blog/2019/07/26/compound-presentation/
How is compound presentation diagnosed? 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.
https://www.obstetricexcellence.com.au/babys-hand-below-head-in-labour/
Compound presentation is reported to occur in 1 in 700 to 1 in 1,000 deliveries. A compound presentation is usually the baby’s hand or arm presenting with the head but the definition includes the presentation of any foetal extremity alongside the presenting part.
https://exxcellence.org/list-of-pearls/management-of-brow-face-and-compound-malpresentations/
Aug 01, 2018 · Five percent of fetuses present in brow, face, or compound presentations, many of which result in vaginal delivery. Patients should be counseled about increased risk for cesarean delivery due to fetal distress, labor arrest, or persistent malpresentations.
https://www.mumsnet.com/Talk/childbirth/235100-question-for-midwives-compound-presentations
In my (extremely limited) experience, compound presentations are rarely apparent until the last minute, as baby is actually delivering. I guess I would try to limit damage to the perineum by controlling the delivery and let the perineum stretch as much as possible (but would try and do that anyway ) Might be more hands-on than normal.
https://medical-dictionary.thefreedictionary.com/compound+presentation
compound presentation prolapse of one of the limbs of the fetus alongside the head in cephalic presentation or of one or both arms alongside a presenting breech at the beginning of labor. footling presentation presentation of the fetus with one foot (single footling) or two feet (double footling) prolapsed into the maternal vagina.
https://www.abclawcenters.com/practice-areas/prenatal-birth-injuries/abnormal-position-or-presentation/
Often, the safest way to deliver a baby with compound presentation is C-section, because complications like dystocia and cord prolapse carry risks of severe adverse outcomes, including cerebral palsy, intellectual and developmental disabilities, and hypoxic-ischemic encephalopathy (HIE) (3).
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