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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 .
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 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:
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]
They may also be referred to as delivery positions or labor positions. In addition to the lithotomy position (on back with feet pulled up), still commonly used by many obstetricians , other positions are successfully used by midwives and traditional birth-attendants around the world.
Posterior shoulder in obstetrics refers to the shoulder of the fetus other than the anterior shoulder. Thus, the posterior shoulder faces the rectum of the mother during delivery. Whether left or the right shoulder becomes the posterior shoulder is dependent upon the original position of the fetus.
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]
Jacquemier's maneuver (also called Barnum's maneuver), or delivery of the posterior shoulder first, in which the forearm and hand are identified in the birth canal, and gently pulled; Gaskin maneuver involves moving the mother to an all fours position with the back arched, widening the pelvic outlet. [24] [25] More drastic maneuvers include: