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The management of persistent occipito-posterior position
A Neri1, B Kaplan, D Rabinerson
1Department of Obstetrics and Gynecology, Beilinson Medical Center, Petah Tiqva, Tel Aviv, Israel.
Clinical and Experimental Obstetrics & Gynecology
|January 1, 1995
Summary
Persistent occipito-posterior position (POP) complicates 1% of labors. This study found POP associated with increased instrumental deliveries and prolonged labor, suggesting a conservative management approach despite these risks.
Area of Science:
- Obstetrics and Gynecology
- Perinatal Medicine
Background:
- Persistent occipito-posterior position (POP) affects approximately 1% of deliveries.
- Management strategies for POP remain a subject of debate in obstetrics.
Purpose of the Study:
- To analyze prepartum, intrapartum, and postpartum parameters in patients with persistent occipito-posterior position.
- To compare outcomes between women with POP and a matched control group.
Main Methods:
- Retrospective analysis of 319 patients with POP deliveries.
- Matching a control group of 319 patients for maternal age, gravidity, and parity.
- Statistical comparison of various obstetric parameters between the two groups.
Main Results:
- Significant differences observed in instrumental delivery rates (forceps/vacuum), prolonged second stage of labor, pregnancy-induced hypertension, prostaglandin E2 induction, premature rupture of membranes, and episiotomy.
- Higher incidence of these complications in the POP group compared to controls.
Conclusions:
- The findings highlight increased risks associated with persistent occipito-posterior position, including a high rate of instrumental deliveries.
- Despite these risks, a conservative management approach is advocated over aggressive intervention for POP labors.