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In an occiput posterior position, labor becomes prolonged, and more operative interventions are deemed necessary. [4] The prevalence of the persistent occiput posterior is given as 4.7%. [4] The vertex presentations are further classified according to the position of the occiput, both right, left, or transverse and anterior or posterior:
Sacrum posterior (SP)—the buttocks face posteriorly. Shoulder presentations with transverse lie are classified into four types, based on the location of the scapula (shoulder blade). This presentation needs to be delivered by cesarean section. Left scapula-anterior (LSA) Right scapula-anterior (RSA) Left scapula-posterior (LSP)
In obstetrics, position is the orientation of the fetus in the womb, identified by the location of the presenting part of the fetus relative to the pelvis of the mother. Conventionally, it is the position assumed by the fetus before the process of birth, as the fetus assumes various positions and postures during the course of childbirth .
Various techniques have been tried to resolve an asynclitic position of the fetus. Vacuum extraction, a delivery assistance method used for prolonged or obstructed labor, has been shown to reverse the position from the less optimal one, known as occiput posterior or occiput transverse, to the more favorable position known as occiput anterior. [22]
Other factors are a lax abdominal musculature, uterine overdistension (i.e., polyhydramnios), multiple gestation, placenta previa, a small fetus, or a fetus with some abnormality. Further, if the amniotic fluid sac ruptures, the shoulder or arm may become wedged as a shoulder presentation.
This position is convenient for the caregiver because it permits them more access to the perineum. The position has been largely popular in the US and other Western countries over the last two centuries, though cross-culturally and historically, it is very rare (about 18%) for people to assume a prone or dorsal position during childbirth.
Retroverted uterus; Other names: Tipped uterus: A transvaginal ultrasound showing a retroverted uterus during pregnancy. The cervix lies posteriorly to the urinary bladder, and the uterus normally extends superiorly from it, but the direction of the body of the fetus reveals that the uterus extends backwards.
Furthermore, the long axis of the body of the uterus is bent forward at the level of the internal os with the long axis of the cervix. This position is termed anteflexion of the uterus. [17] The uterus assumes an anteverted position in 50% of women, a retroverted position in 25% of women, and a midposed position in the remaining 25% of women. [2]