Obstetrics Book

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Manual Rotation in Occipitoposterior Presentation

Aka: Manual Rotation in Occipitoposterior Presentation
  1. See Also
    1. Occiput Posterior
    2. Labor Dystocia
  2. Indications
    1. Occiput Posterior and Failure to Progress
  3. Safety
    1. Low risk procedure (but does require training)
  4. Technique
    1. Flex fetal head
      1. Place hand in posterior Pelvis behind occiput
      2. Wedge head into flexion
    2. Rotate head
      1. Perform during contraction with mother pushing
      2. OP: Examiner pronates dominant hand on exam
      3. ROP: Examiner pronates left hand clockwise
      4. LOP: Examiner pronates right hand counter clockwise
  5. Efficacy
    1. Significantly reduces cesareans in OP Presentation
      1. Shaffer (2006) Am J Obstet Gynecol194:e7-9 [PubMed]

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