North American Registry of Midwives (NARM) Practice Exam

Attitudes of extension typically lead to which fetal presentations?

1. Brow and Face

2. Transverse and Oblique

3. Anterior and Posterior

4. Vertex and Breech

The correct answer is: Brow and Face

The option that indicates an accurate association with attitudes of extension in fetal presentations is brow and face. In the context of childbirth, extension refers to the position of the fetal head during labor. When a fetus is in an extended position, it means that the chin is tilted away from the chest, which can lead to presentations where the forehead (brow) or the face appears first in the birth canal. In a brow presentation, the largest part of the fetal head (the forehead) leads, while in a face presentation, the fetal face is the presenting part. Both of these positions result from extension of the fetal neck and head and are more likely when the fetal head is not flexed into a typical vertex position. Other presentations, such as transverse or oblique, indicate the fetus lying sideways or at a diagonal angle, which are not characterized by extension but rather by variations in orientation. Similarly, vertex (the top of the head) and breech (the buttocks or feet) are more typical flexed positions of the fetus and do not represent extension. Therefore, brow and face presentations are directly influenced by the extension of the fetal neck, making them the correct association in this scenario.