Persistent Occiput Posterior: OUTcomes following digital rotation: A pilot randomised controlled trial

Abstract

A large double-blinded multicentre RCT would be feasible and acceptable to women and staff. Strategies to improve recruitment such as consenting women with an effective epidural in active labour should be considered. This would be the first RCT to answer a clinically important question which could significantly affect the operative delivery rate in Australia and internationally.

How Can Manual Rotation Reduce Vacuum, Forceps and Caesarean Deliveries?—A Review of the Evidence

“…There were two Cohort studies [14] [27] one Case-control study [13] and one Pilot study [28]. The rest were a mix of retrospective and prospective studies [29] [30] [31].…”

“…The article by Graham et al [28] is a pilot study. Although it is of medium methodological quality, the results are not be of great importance for this paper due to the small population, that makes the study underpowered to test the efficiency of prophylactic DR.…”

“…The authors based their reasons for arguing that MR can reduce VD, FD and CD on two different findings. Reichman et al [30], Shaffer et al [14], Le Ray et al [29] and Graham et al [28] were influenced by the findings related to mode of delivery after MR versus expectant management.…”

“…Three of the included studies described rotation of OP positions [28] Le Ray et al [29] referred to the success rate when comparing rotation from the two positions, although they did not observe any difference in the success of rotations from OT and OP positions.…”

“…Reichman et al [30] and Le Ray et al [29] found an increase in spontaneous vaginal delivery of 50.1% and 15.5% after MR. The study by Graham et al [28] lacks the power to provide answers on rates.…”