Is maternal posturing during labor efficient in preventing persistent occiput posterior position? A randomized controlled trial.

Abstract:

OBJECTIVE:We sought to evaluate the efficacy of maternal posturing during labor on the prevention of persistent occiput posterior (OP) position. STUDY DESIGN:We conducted a randomized trial including 220 patients in labor with a single fetus in documented OP position. Main outcome was the proportion of anterior rotation from OP position. RESULTS:The rates of anterior rotation were, respectively, 78.2% and 76.4% in the intervention group and the control group without significant difference (P = .748). Rates of instrumental and cesarean section deliveries were not significantly different between intervention and control groups (18.2% vs. 19.1%, P = .89, and 19.1% vs. 17.3%, P = .73, respectively). In intervention and control groups, persistent OP position rates were significantly higher among women who had cesarean section (71.4% and 89.5%, respectively) and an instrumental delivery (25% and 33.3%, respectively) than among women who achieved spontaneous vaginal birth (5.8% and 2.8%, respectively). In multivariable analysis, body mass index and parity were found to have significant and independent impact on the probability of fetal head rotation. CONCLUSION:Our study failed to demonstrate any maternal or neonatal benefit to a policy of maternal posturing for the management of OP position during labor.

journal_name

Am J Obstet Gynecol

authors

Desbriere R,Blanc J,Le Dû R,Renner JP,Carcopino X,Loundou A,d'Ercole C

doi

10.1016/j.ajog.2012.10.882

subject

Has Abstract

pub_date

2013-01-01 00:00:00

pages

60.e1-8

issue

1

eissn

0002-9378

issn

1097-6868

pii

S0002-9378(12)02029-7

journal_volume

208

pub_type

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