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Department of Reproductive Health and Research (RHR), World Health Organization

Managing Complications in Pregnancy and Childbirth

A guide for midwives and doctors 


Section 2 - Symptoms

Table S-11

 Diagnosis of malpositions

Symptoms  and Signs


OCCIPUT POSTERIOR POSITION occurs when the fetal occiput is posterior in relation to the maternal pelvis (Fig S-13 and Fig S-14).

On abdominal examination, the lower part of the abdomen is flattened, fetal limbs are palpable anteriorly and the fetal heart may be heard in the flank.

On vaginal examination, the posterior fontanelle is towards the sacrum and the anterior fontanelle may be easily felt if the head is deflexed.

For management



OCCIPUT TRANSVERSE POSITION occurs when the fetal occiput is transverse to the maternal pelvis (Fig S-15). If an occiput transverse position persists into the later part of the first stage of labour, it should be managed as an occiput posterior position.



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