The Role Of Manual Rotation In Avoiding And Managing Ovd

Publication date: Available online 13 December 2018Source: Best Practice & Research Clinical Obstetrics & GynaecologyAuthor(s): Stephen O’Brien, Sharon Jordan, Dimitrios SiassakosAbstractManual rotation is the most common technique used by accoucheurs wishing to correct malposition of the fetal head, to either avoid or facilitate an operative vaginal delivery. Manual rotation can be performed using either a whole-hand or digital approach. Manual rotation should be formally taught, trainees should be assessed for competence, and later performance should ideally be tracked with statistical control charts. There is paucity of robust evidence evaluating manual rotation relative to the other methods of rotational operative vaginal delivery; rotational forceps and rotational ventouse. Furthermore, there is little evidence concerning long-term maternal outcomes of rotational operative vaginal delivery. A prospective randomized trial of manual rotation versus either rotational forceps or rotational ventouse is clearly needed, along with a core outcome set for operative vaginal delivery to facilitate comprehensive evaluation programmes that focus on what matters to women.
Source: Best Practice and Research Clinical Obstetrics and Gynaecology - Category: OBGYN Source Type: research