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Manual Rotation in Occipitoposterior Presentation

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1. Manual Rotation in Occipitoposterior Presentation

Manual Rotation in Occipitoposterior Presentation Manual Rotation in Occipitoposterior Presentation Toggle navigation Brain Head & Neck Chest Endocrine Abdomen Musculoskeletal Skin Infectious Disease Hematology & Oncology Cohorts Diagnostics Emergency Findings Procedures Prevention & Management Pharmacy Resuscitation Trauma Emergency Procedures Ultrasound Cardiovascular Emergencies Lung Emergencies Infectious Disease Pediatrics Neurologic Emergencies Skin Exposure Miscellaneous Abuse Cancer (...) Administration 4 Manual Rotation in Occipitoposterior Presentation Manual Rotation in Occipitoposterior Presentation Aka: Manual Rotation in Occipitoposterior Presentation II. Indications and III. Safety Low risk procedure (but does require training) IV. Technique Flex fetal head Place hand in posterior behind occiput Wedge head into flexion Rotate head Perform during contraction with mother pushing OP: Examiner pronates dominant hand on exam ROP: Examiner pronates left hand clockwise LOP: Examiner pronates

2018 FP Notebook

2. Manual Rotation in Occipitoposterior Presentation

Manual Rotation in Occipitoposterior Presentation Manual Rotation in Occipitoposterior Presentation Toggle navigation Brain Head & Neck Chest Endocrine Abdomen Musculoskeletal Skin Infectious Disease Hematology & Oncology Cohorts Diagnostics Emergency Findings Procedures Prevention & Management Pharmacy Resuscitation Trauma Emergency Procedures Ultrasound Cardiovascular Emergencies Lung Emergencies Infectious Disease Pediatrics Neurologic Emergencies Skin Exposure Miscellaneous Abuse Cancer (...) Administration 4 Manual Rotation in Occipitoposterior Presentation Manual Rotation in Occipitoposterior Presentation Aka: Manual Rotation in Occipitoposterior Presentation II. Indications and III. Safety Low risk procedure (but does require training) IV. Technique Flex fetal head Place hand in posterior behind occiput Wedge head into flexion Rotate head Perform during contraction with mother pushing OP: Examiner pronates dominant hand on exam ROP: Examiner pronates left hand clockwise LOP: Examiner pronates

2015 FP Notebook

3. Occiput Posterior

Posterior , Occipitoposterior Malpresentation , OP Presentation From Related Chapters II. Definition Abnormal with occiput at maternal Fetal face towards maternal symphysis pubis III. Epidemiology Represents 10% of s IV. Physiology Less favorable fetal head diameter for delivery Deflexion of fetal head Posterior presentation Usually corrects spontaneously Rotates to position in 90% of cases V. Symptoms Back labor Prolonged labor Nulliparous: Additional two hours Multiparous: Additional one hour VI (...) . Signs: Digital cervical exam Asymmetric cervical dilation Persistant anterior lip Palpation of fetal head Fetal anterior most palpable Follow sagittal to posterior Posterior , lambdoid with be posterior VII. Complications Extended episiotomy or perineal VIII. Management Spontaneous Delivery (anticipate in 45% of cases) Maternal position changes (unclear efficacy) Any position in which mother curls forward from hips Hands and knees Squatting Manual rotation during vaginal exam See Vacuum Delivery

2018 FP Notebook

4. Operative Vaginal Delivery (Consent Advice)

for shoulder dystocia ? Caesarean section ? Blood transfusion ? Repair of perineal tear ? Manual rotation prior to forceps or vacuum-assisted delivery. 6. What the procedure is likely to involve, the benefits and risks of any available alternative treatments, including no treatment Delivery of the baby (or babies) vaginally by means of forceps or a vacuum device. A clinical assessment is performed before the instrument is applied. The operator will choose the instrument most appropriate to the clinical (...) that all women are given consistent and adequate information for consent; it is intended to be used together with dedicated patient information. After discharge women should have clear direction to obtaining help if there are unforeseen problems. Clinicians should be prepared to discuss with the women any of the points listed on the following pages. The above descriptors are based on the RCOG Clinical Governance Advice, Presenting Information on Risk. 3 They are used throughout this document. To assist

2010 Royal College of Obstetricians and Gynaecologists

5. Clinical Practice Guideline on Care in Normal Childbirth

Practice Guideline and it is subject to updating. CLINICAL PRACTICE GUIDELINE ON CARE IN NORMAL CHILDBIRTH 5 Contents Presentation 9 Authorship and Collaboration 11 Questions to Be Answered 15 Levels of Evidence and Grades of Recommendations 21 CPG Recommendations 23 1. Introduction 35 2. Scope and Aims 37 3. Methods 39 4. Care During Childbirth 43 4.1. Care by Professionals and Those Accompanying 43 4.2. Ingestion of Fluids and Solids 51 5. First Stage of Labour 57 5.1. Definition of the First Stage (...) the publication of this Clinical Practice Guideline and it is subject to updating. CLINICAL PRACTICE GUIDELINES IN THE SPANISH HEALTHCARE SYSTEM 8 It has been 5 years since the publication of this Clinical Practice Guideline and it is subject to updating. CLINICAL PRACTICE GUIDELINE ON CARE IN NORMAL CHILDBIRTH 9 Presentation Although scientific information is more accessible now than ever, the sheer volume of information leads to a need for certain tools which aim to support suitable, efficient, safe

2010 GuiaSalud

6. Occiput Posterior

Posterior , Occipitoposterior Malpresentation , OP Presentation From Related Chapters II. Definition Abnormal with occiput at maternal Fetal face towards maternal symphysis pubis III. Epidemiology Represents 10% of s IV. Physiology Less favorable fetal head diameter for delivery Deflexion of fetal head Posterior presentation Usually corrects spontaneously Rotates to position in 90% of cases V. Symptoms Back labor Prolonged labor Nulliparous: Additional two hours Multiparous: Additional one hour VI (...) . Signs: Digital cervical exam Asymmetric cervical dilation Persistant anterior lip Palpation of fetal head Fetal anterior most palpable Follow sagittal to posterior Posterior , lambdoid with be posterior VII. Complications Extended episiotomy or perineal VIII. Management Spontaneous Delivery (anticipate in 45% of cases) Maternal position changes (unclear efficacy) Any position in which mother curls forward from hips Hands and knees Squatting Manual rotation during vaginal exam See Vacuum Delivery

2015 FP Notebook

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