| Persistent fetal occiput posterior position: obstetric outcomes. | |
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MedLine Citation:
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PMID: 12738150 Owner: NLM Status: MEDLINE |
Abstract/OtherAbstract:
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OBJECTIVE: To evaluate the obstetric outcomes associated with persistent occiput posterior position of the fetal head in term laboring patients. METHODS: We performed a cohort study of 6434 consecutive, term, vertex, laboring nulliparous and multiparous patients, comparing those who delivered infants in the occiput posterior position with those who delivered in the occiput anterior position. We examined maternal demographics, labor and delivery characteristics, and maternal and neonatal outcomes. RESULTS: The prevalence of persistent occiput posterior position at delivery was 5.5% overall, 7.2% in nulliparas, and 4.0% in multiparas (P <.001). Persistent occiput posterior position was associated with shorter maternal stature and prior cesarean delivery. During labor and delivery, the occiput posterior position was associated with prolonged first and second stages of labor, oxytocin augmentation, use of epidural analgesia, chorioamnionitis, assisted vaginal delivery, third and fourth degree perineal lacerations, cesarean delivery, excessive blood loss, and postpartum infection. Newborns had lower 1-minute Apgar scores, but showed no differences in 5-minute Apgar scores, gestational age, or birth weight. CONCLUSION: Persistent occiput posterior position is associated with a higher rate of complications during labor and delivery. In our population, the chances that a laboring woman with persistent occiput posterior position will have a spontaneous vaginal delivery are only 26% for nulliparas and 57% for multiparas. |
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Authors:
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Susan E Ponkey; Amy P Cohen; Linda J Heffner; Ellice Lieberman |
Publication Detail:
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Type: Journal Article |
Journal Detail:
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Title: Obstetrics and gynecology Volume: 101 ISSN: 0029-7844 ISO Abbreviation: Obstet Gynecol Publication Date: 2003 May |
Date Detail:
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Created Date: 2003-05-09 Completed Date: 2003-06-03 Revised Date: 2009-10-26 |
Medline Journal Info:
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Nlm Unique ID: 0401101 Medline TA: Obstet Gynecol Country: United States |
Other Details:
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Languages: eng Pagination: 915-20 Citation Subset: AIM; IM |
Affiliation:
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Department of Obstetrics and Gynecology, Brigham and Women's Hospital, Boston, Massachusetts, USA. |
Export Citation:
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| MeSH Terms | |
Descriptor/Qualifier:
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Apgar Score Body Height Cesarean Section Cohort Studies Female Humans Labor Presentation* Labor, Induced Obstetric Labor Complications / epidemiology* Parity Pregnancy Prevalence |
From MEDLINE®/PubMed®, a database of the U.S. National Library of Medicine
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