Procedure

Manual Rotation in Occipitoposterior Presentation

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Manual Rotation in Occipitoposterior Presentation

  • See Also
  1. Occiput Posterior
  2. Labor Dystocia
  • Indications
  1. Occiput Posterior and Failure to Progress
  • Safety
  1. Low risk procedure (but does require training)
  • 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
  • Efficacy
  1. Significantly reduces cesareans in OP Presentation
    1. Shaffer (2006) Am J Obstet Gynecol194:e7-9 [PubMed]