Influence of Persistent Occiput Posterior Position on Delivery Outcome

Outcome of labor in vertex malposition in Cameroon

“…1,6,15 Because of low spontaneous rotation rate, our rate of persistent OP position at delivery (3.0%) is within the range of 1.8% to 6.0% found elsewhere. 6,11,15 In our series, women with VM were usually nulliparous (51%) as noticed elsewhere. 6,16 This might be explained by the fact that some of these nulliparous women might have had a borderline pelvis which is a known risk factor for VM.…”

“…[3][4][5] Risk factors for VM include nulliparity, maternal obesity, excessive fetal weight, pelvic (especially mid cavity) immaturity or abnormalities, epidural anesthesia and labor augmentation. 2,6,7 Diagnosis of OP position is done through a digital vaginal examination which finds the lambda fontanel towards the maternal sacrum. For Occipito-Transverse (OT) position, the lambda fontanel is situated at the maternal left or right sides.…”

“…Under efficient uterine contractions, an OP position may also correct itself during labor with the delivery in OA position. 1,6 This is more common in multiparous than in primiparous women. 6 Around 5-11% of cases of malposition persist till delivery.…”

“…1,6 This is more common in multiparous than in primiparous women. 6 Around 5-11% of cases of malposition persist till delivery. 1,3,5,11 Although instrumental vaginal deliveries are commoner in cases of VM, vacuum extraction is associated with higher failure rate than (Kielland's) forceps.…”

Recurrent persistent occipito‐posterior position in subsequent deliveries

“…5 Persistent occiput posterior position occurs more often in primiparous women. 6 Little is known about the recurrence of persistent occiput posterior position in subsequent deliveries. Our clinical impression is that this problem recurs in subsequent deliveries relatively often, and that the reproductive pattern might be altered by complicated deliveries in the persistent occiput posterior position.…”