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Related Concept Videos

Anatomical Positions01:11

Anatomical Positions

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In anatomy, several standard anatomical positions are used as references for describing the position and orientation of different body parts. These positions help provide a common frame of reference when discussing anatomical structures. The anatomical position is the standard reference point for describing the body's position and orientation. In this position:
The body is upright, facing forward, and standing erect.
The feet are parallel and flat on the floor.
The arms are hanging by the...
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External Cephalic Version: Is it an Effective and Safe Procedure?
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Instrumental rotation for persistent fetal occiput posterior position: a way to decrease maternal and neonatal

Fabien Vidal1, Caroline Simon, Christelle Cristini

  • 1CHU Toulouse, Pole de Gynécologie Obstétrique, Hôpital Paule de Viguier, Toulouse, France.

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Instrumental rotation with Thierry's spatulas for persistent occiput posterior positions did not reduce maternal or neonatal complications. Further research is needed to determine the procedure's value in modern obstetrics.

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Area of Science:

  • Obstetrics and Gynecology
  • Perinatal Medicine
  • Surgical Innovation

Background:

  • Persistent occiput posterior (OP) positions complicate vaginal delivery.
  • Instrumental rotations are used to manage OP presentations.
  • Thierry's spatulas are one instrument for rotational maneuvers.

Purpose of the Study:

  • To assess the immediate maternal and neonatal morbidity associated with instrumental rotations using Thierry's spatulas.
  • To compare outcomes of persistent OP deliveries managed with instrumental rotation versus other methods.

Main Methods:

  • Retrospective study of vaginal deliveries with persistent OP positions (August 2006-September 2007).
  • Included successful instrumental rotations and occiput anterior deliveries.
  • Compared maternal/neonatal outcomes using statistical tests (chi-squared, ANOVA).

Main Results:

  • 157 patients analyzed: 46 spontaneous OP, 58 assisted OP, 53 post-rotational deliveries.
  • Instrumental rotation failed in 9 cases.
  • No significant differences in severe perineal tears or neonatal adverse outcomes among groups.

Conclusions:

  • Instrumental rotation with Thierry's spatulas did not lower maternal or neonatal morbidity in persistent OP deliveries.
  • The clinical utility of this rotational technique requires further investigation.