Vacuum extraction successful in most of cases with an occiput posterior position: Study

Persistent occiput posterior (OP) position occurs in approximately 5% of women in the second stage of labor and is a risk factor for labor complications. These complications include a 50% rate of labor arrest during the second stage, an over 60% rate of cesarean or instrumental vaginal delivery and an almost 20% incidence of obstetrical anal sphincter injuries. Persistent OP position is among the strongest risk factors for failed instrumental vaginal delivery and is also associated with increased frequency of neonatal complications, such as a 3% rate of neonatal acidemia, a 10% rate of neonatal morbidity and an 80% higher risk of birth trauma mostly due to failed operative delivery. Digital vaginal examination is considered the standard of care in the assessment of fetal position in labor.