II. Definition
- Abnormal Fetal Position with occiput at maternal Sacrum
- Fetal face towards maternal Symphysis Pubis
III. Epidemiology
- Represents 10% of Fetal Positions
IV. Physiology
- Less favorable fetal head diameter for delivery
- Deflexion of fetal head
- Posterior presentation
- Usually corrects spontaneously
- Rotates to Occiput Anterior position in 90% of cases
V. Symptoms
- Back labor
- Prolonged labor
- Nulliparous: Additional two hours
- Multiparous: Additional one hour
VI. Signs: Digital cervical exam
VII. Complications
- Failure to Progress
- Extended episiotomy or perineal Laceration
VIII. Management
- Spontaneous Delivery (anticipate in 45% of cases)
- Maternal position changes (unclear efficacy)
- Any position in which mother curls forward from hips
- Hands and knees
- Squatting
- Manual rotation during vaginal exam
- Vacuum Delivery
- Place vacuum cup as posterior as possible
- Inproves flexion of fetal head
- Do not use vacuum to rotate fetal head
- Results in Scalp Laceration
- Place vacuum cup as posterior as possible
- Forceps Delivery
- Forceps Rotation (skilled clinician only)
- Techniques: Scanzoni or Kielland
- Requires immediate Ceserean back-up
- Rarely performed in U.S. now
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Related Studies
| Concepts | Pathologic Function (T046) |
| SnomedCT | 60949004, 206114009 |
| English | Fetus born-persist.occip-post., Fetus or neonate affected by persistent occipito-posterior malposition during labor and delivery, Fetus or neonate affected by persistent occipito-posterior malposition during labour and delivery, Fetus/neonate affect persistent occip-posterior - labor/del, Fetus/neonate affect persistent occip-posterior - labour/del, fetus / newborn affected by persistent occipitoposterior position, fetus or newborn affected by persistent occipitoposterior position (diagnosis), fetus or newborn affected by persistent occipitoposterior position, Fetus OR newborn affected by persistent occipitoposterior position (disorder), Foetus or neonate affected by persistent occipito-posterior malposition during labour and delivery, Fetus OR newborn affected by persistent occipitoposterior position, Fetus or neonate affected by persistent occipito-posterior malposition during labor and delivery (disorder), occipitoposterior position; persistent, affecting fetus or newborn, persistent; occipitoposterior position, affecting fetus or newborn, Fetus or newborn affected by persistent occipitoposterior position |
| Spanish | feto o neonato afectado por posición anómala occipitoposterior persistente durante el trabajo de parto y parto (trastorno), feto O recién nacido afectado por posición occipitoposterior persistente, feto o neonato afectado por posición anómala occipitoposterior persistente durante el trabajo de parto y parto, feto O recién nacido afectado por posición occipitoposterior persistente (trastorno) |
| Dutch | occipitoposterieure ligging; persisterend, gevolgen voor foetus of pasgeborene, persisterend; occipitoposterieure ligging, gevolgen voor foetus of pasgeborene |
