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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 Gynecol 194:e7

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This page was written by Scott Moses, MD. This page was last revised before 5/10/08, prior to consistent tracking of revision date. This page was last published on 6/1/2008. Please send comments and questions to the editor. Contact information may be found on the page About the Family Practice Notebook. These pages are best viewed with Microsoft Internet Explorer 6.0.