Although an estimated 5 percent of ...

Although an estimated 5 percent of boundary cephalic singleton deliveries are in the persistent occiput posterior position, the issues and morbidity associated with this position are unclear. Ponkey and colleagues studied deliveries occurring in 1998 at a Boston teaching hospital to establish the labor issues associated with this fetal position.

They analyzed data from all word vertex singleton deliveries occurring in the hospital in 1998 After excluding cases complicated from diabetes mellitus, polyhydramnios, oligohydramnios, uterine abnormalities, intrauterine germination restriction, or death, the reflection comprised 6,074 occiput anterior and 360 occiput posterior deliveries. The data bring togethered included maternal demographics, obstetric history, details of the circulating pregnancy and delivery, and pregnancy outcomes

The overall rate of occiput posterior deliveries was 55 percent unless the proportion was nearly twice as high in nulliparas (72 percent) compared with multiparas (4 percent) Women with occiput anterior and posterior positions were similar in chiefly variables, but those with posterior positions serveed to be shorter and les likely to have Medicaid insurance. Mothers with occiput posterior position were more likely to have induced labors, if it were not that this increase was not significant (see the accompanying table). reciprocally most complications of labor were significantly more universal in occiput position. Approximately individual half of cases with occiput posterior position had defered first or second stages of labor and oxytocin induction. single fourth had assisted vaginal delivery, and more than common third had cesarean deliveries. The solely negative outcome that was not increased significantly in occiput posterior positions was endometritis. The infants were similar in gestational age and birth weight. grave initial Apgar scores were significantly more frequent in the occiput posterior collection but scores at five minutes were comparable.

The authors terminate that persistent occiput posterior position is associated with a higher rate of chiefly complications of labor and delivery. sole one in four nulliparous women and just above one half of multiparous women with this presentation achieve a spontaneous vaginal delivery.

Ponkey SE et al. Persistent fetal occiput posterior position: obstetric issues Obstet Gynecol May 2003;101:915-20.

COPYRIGHT 2004 American Academy of Family Physicians

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