title: Fetal malposition: impact and management.
abstract: Fetal malposition, either occiput posterior or transverse (OT), leads to greater risk of cesarean delivery, prolonged labor, and increased perinatal morbidity. Historically, there is a known association between epidural use and malposition that was assumed to be due to the increased discomfort of laboring with a fetus in the occiput posterior position. However, evidence now suggests that the epidural itself may contribute to fetal malposition by impacting the probability of internal rotation. Fetal malposition may be impacted by manual rotation. Manual rotation has been associated with greater rates of delivering in the occiput anterior position and lower rates of cesarean delivery.
authors: *Oregon Health & Science University, Department of Obstetrics & Gynecology, Portland, Oregon †Department of Obstetrics and Gynecology, University of California Davis, Sacramento, California.
authors: Aaron B
authors: AB
authors: Caughey
authors: Rita
authors: R
authors: Sharshiner
authors: Yvonne W
authors: YW
authors: Cheng
mesh_terms: D015360:Analgesia, Epidural / Q000009:adverse effects / Q000379:methods; D002585:Cesarean Section / Q000009:adverse effects / Q000379:methods; D005260:Female; D006801:Humans; D007746:Labor Presentation; D026201:Musculoskeletal Manipulations / Q000009:adverse effects / Q000379:methods; D007744:Obstetric Labor Complications / Q000175:diagnosis / Q000209:etiology / Q000628:therapy; D011247:Pregnancy; D011256:Pregnancy Outcome; D020379:Risk Adjustment; D061665:Time-to-Treatment