Occiput posterior position diagnosis: Vaginal examination or intrapartum sonography? A clinical review

The occiput posterior (OP) position is one of the most frequent malposition during labor. During the first stage of labor, the fetal head may stay in the OP position in 30% of the cases, but of these only 5-7% remains as such at time of delivery. The diagnosis of OP position in the second stage of labor is made difficult by the presence of the caput succedaneum or scalp hair, both of which may give some problem in the identification of fetal head sutures and fontanels and their location in relationship to maternal pelvic landmarks. The capability of diagnosing a fetus in OP position by digital examination has been extremely inaccurate, whereas an ultrasound approach, transabdominal, transperineal and transvaginal, has clearly shown its superior diagnostic accuracy. This is true not only for diagnosis of malpositions, detected in both first and second stage of labor, but also in cases of marked asynclitism. © 2014 Informa UK Ltd. All rights reserved: reproduction in whole or part not permitted.

Malvasi A.1 , Tinelli A.2 , Barbera A.3, 4, 5 , Eggebo T.M.6 , Mynbaev O.A. 7, 8 , Bochicchio M.9 , Pacella E.10 , Di Renzo G.C.
Taylor and Francis Ltd
Номер выпуска
  • 1 Santa Maria Hospital, Gynecology and Obstetric, Bari, Italy
  • 2 Gynecology and Obstetric, Vito Fazzi Hospital, P.zza Muratore, Lecce, 73100, Italy
  • 3 School of Medicine, University of Colorado Denver, Aurora, CO, United States
  • 4 Denver Health Medical Center, Denver, CO, United States
  • 5 Department of Obstetrics and Gynecology, Denver, CO, United States
  • 6 Department of Obstetrics and Gynecology, Stavanger University Hospital, Stavanger, Norway
  • 7 Department of ObGyn and Reproductive Medicine, Moscow State University of Medicine and Dentistry, Peoples' Friendship University of Russia, Moscow, Russian Federation
  • 8 Moscow Institute of Physics and Technology, State University, Moscow, Russian Federation
  • 9 Software Engineering and TeleMedia Lab (SET-Lab), University of Salento, Italy
  • 10 Department of Sense Organs, Faculty of Medicine and Dentistry, Sapienza University of Rome, Italy
  • 11 Department of Ob/Gyn, Centre for Perinatal Medicine, Santa Maria della Misericordia University Hospital, Perugia, Italy
Ключевые слова
Digital examination; Labor; Malpresentation; Occiput posterior position; Ultrasounds
Дата создания
Дата изменения
Постоянная ссылка

Другие записи