§ Digital rotation from occipito-posterior to occipito-anterior decreases the need for cesarean section

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Abstract

Objectives:

The purpose of this study was to evaluate the effectiveness of digital rotation to reduce both the incidence of POP and the associated negative effects on maternal well-being.

Study design:

This was a prospective study in which, during the first half of the study period, the women recruited were allowed to continue to labour as usual (non-intervention group), while those recruited into the second half of the study underwent digital rotation (intervention group).

Participants/sample:

In the second stage of labour, 61 women with a singleton pregnancy with the fetal head in an OP position were enrolled prospectively into the study.

Results:

The study found that digital/manual rotation resulted in a significant increase in OA positions (93% in the intervention group as compared to 15% in the nonintervention group), spontaneous vaginal births (77% in the intervention group as compared to 27% in the nonintervention group) and a corresponding decrease in assisted and operative deliveries following digital rotation.

Key conclusions:

The authors conclude that digital rotation should be considered when managing a labour with a fetus in the OP position and highlight, when the manoeuvre is successful, that it rotates the fetus into an OA position and reduces the need for assisted and operative delivery with its associated morbidities.

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