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Occiput posterior position

Authors
Cynthia Holcroft Argani, MD
Andrew J Satin, MD, FACOG
Section Editor
Susan M Ramin, MD
Deputy Editor
Vanessa A Barss, MD, FACOG

INTRODUCTION

Occiput posterior (OP) position (figure 1) is the most common fetal malposition. It is important because it is associated with labor abnormalities that may lead to adverse maternal and neonatal consequences.

PREVALENCE AND PATHOGENESIS

The prevalence of OP position depends on when the diagnosis is made. Before labor, 15 to 20 percent of term fetuses in cephalic presentation are OP, but only 5 percent are OP at vaginal delivery because most OP fetuses spontaneously rotate to an anterior position during labor [1-5]. In some cases, the OP position at delivery results from malrotation from an occiput anterior (OA) or occiput transverse (OT) position [2]; however, this is unlikely once the second stage has begun [6].

RISK FACTORS

Reported risk factors for OP position at delivery include [6-13]:

Nulliparity

Maternal age greater than 35 years

              

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Literature review current through: Jun 2015. | This topic last updated: Apr 8, 2015.
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