TARLAC STATE UNIVERSITY

COLLEGE OF SCIENCE
DEPARTMENT OF NURSING
Awarded Level III Status by the Accrediting Agency of Chartered Colleges and Universities in thePhilippines

JOURNAL READING
Reference
Yang, L. (2021). Clinical effectiveness of position management and manual rotation of the fetal
position with a U-shaped birth stool for vaginal delivery of a fetus in a persistent
occiput posterior position. Sage Journals.
https://journals.sagepub.com/doi/10.1177/0300060520924275?icid=int.sj-
abstract.similar-articles.3
Introduction
Dystocia is frequently caused by an abnormal fetal position during birth. The occiput
posterior position is the most prevalent fetal malposition, accounting for 33.3 percent of all
malposition in labor. The most effective way for addressing the occiput posterior position is
manual rotation of the fetal position. The pregnant woman's posture has a significant impact on
the manual rotation of the fetal position. The goal of this study is to see how position
management, manual fetal position rotation, and the use of a U-shaped birth stool affect
primiparous women with a fetus in a persistent occiput posterior position.

Procedures
A total of 400 primiparous women with a fetus in a persistent occiput posterior position
were included in this study. The women were divided into the position management group and
control group, with 200 women in each group. Four women in the PM group and 12 in the
control group underwent cesarean section. Therefore, analysis was performed in 196 women in
the PM group and 188 in the control group. There were no significant differences in maternal
age, gestational weeks, and newborn weight between the two groups.

The visual analog scale method was used for assessing pain. The stage of perineal
laceration was assessed according to the Royal College of Obstetricians and Gynecologists
(RCOG) criteria. The volume of blood loss at 2 hours after delivery was measured by the
volumetric method and gravimetric method.
Findings and Conclusions
The first and second stages of labor were significantly shorter in the position
management group than in the control group, while the pain score was significantly lower in the
PM group than in the control group. The volume of blood loss at 2 hours after delivery was also
significantly lower in the PM group than in the control group, but there was no significant
difference in the frequency of women with blood loss >250 ml. Therefore, applying position
management, manual rotation of the fetal position, and using a U-shaped birth stool should be
considered for women with a fetus in a persistent occiput posterior position.

In conclusion, adjusting an abnormal fetal position is critical for reducing dystocia of

cephalic presentation and increasing the quality of vaginal delivery. Applying position
management in the first stage of labor, rotation of the fetal position, and use of a U-shaped birth
stool in the second stage of labor to change the occiput posterior position to the occiput anterior
position effectively shorten labor and decrease pain and blood loss in women. Therefore, these
methods are worth considering for women with a fetus in a persistent occiput posterior position.

Personal Comments
In my own idea, position management and U-shaped birth stool device are very essential
especially for mothers who had an occiput posterior position of fetus during labor. It helps
reduce the duration of the labor and delivery which is very beneficial to mothers to decrease the
pain while in the delivery room. I can use this study to my present RLE subject to have enough
knowledge about malposition of fetus even if we were not able to witness it in the area. It is very
necessary since we can use this as a basis when we encounter a case in the LRDR just like this so
that we know what to do right away and what proper management we will give her. We all know
that the most frequent fetal malposition is occiput posterior position which is relevant not just in
this study but also in real life scenario. Position management is critical since it is linked to labor
irregularities that might have negative maternal and newborn effects, especially in the case of
surgical vaginal or cesarean delivery.