[Manual rotation in occiput posterior position: A systematic review in 2019]
I Marguier Blanchard1, J-P Metz1, A Eckman Lacroix1
1Department of obstetrics and gynaecology, Besançon university medical center, Alexander-Fleming boulevard, 25000 Besançon, France.
Objective:
The aim of our study was to evaluate the safety and the benefits of manual rotation in the management of Occiput-posterior positions in 2019.
Methods:
A systematic review of literature was performed using the MEDLINE and COCHRANE LIBRARY databases, in order to identify articles concerning maternal and neonatal outcomes after a manual rotation, through January 2019. Information on study characteristics (review, author, year of publication), population, objectives and main neonatal and maternal outcomes were extracted.
Results:
A total of 51 articles were identified and 12 articles were selected for the systematic review. The rate of successful manual rotation were about 47 to 90%. There were more success if systematic manual rotation, multiparity, engagement, spontaneous labour and maternal age<35. The 2nd stage of labour was shorter after an attempt of manual rotation. The randomised controlled trials did not find any statistical difference concerning operative deliveries or neonatal and maternal outcomes.
Conclusion:
The manual rotation is an obstetrical manoeuvre which must be regulated and only practiced by trained operators. Currently, the state of science is not sufficient to recommend the manual rotation as a systematic practice in 2019.
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