Page 231 - Critical Maternity & Newborn Health Nursing

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Occipto-Posterior Position

Incidence: It occurs in about 15 to 30 % of all labors. ROP is

more common than LOP (4:1) because of:

• The right oblique diameter of the pelvis is slightly longer than the

left oblique diameter due to more use of the right.

• The left oblique diameter is reduced by the presence of pelvic colon.

• Dextrorotation of uterus, this favours OP if the back is on the right

side.

Diagnosis:

Diagnosis of the OP position is made by abdominally &

ultrasonography

A. Inspection:

• The head is flat below the umbilicus (due to absence of the

contour of the fetus back).

• A transverse groove may be seen below the umbilicus.

• Fetal movements may be seen on both sides of the midline.

B. Palpation:

• Fundal level: It corresponds to the period of amenorrhea.

• Fundal grip: The buttocks filling the fundus.

• Umbilical grip: The back felt with difficulty in flanks and limbs

in either sides of midline.

• Pelvic grip:

a. Head is usually not engaged (deflexed head ).

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