When in labor, a diagnosis of occipito-posterior presentation is made. The most appropriate management would be:
Ans. is b, i.e. Wait and watch for progress of laborRef JB Sharma TB of Obs. p 284, Operative Obs and Gynae by Randhir Puri and Narendra Malhotra 7/e, p 173; Williams Obs 23/e, p 479Occipito-posterior positions'Expectant observation is practiced initially as given time, most of the malposition will rotate anteriorly and the baby will be born spontaneously' Ref. JB Sharma Obs. p 284"In practice about 5-10% of women admitted in labor with cephalic presentations present with occipito-posterior presentations. Given time and patience, many of these will rotate and get corrected to occipitoanterior position and deliver normally". --Operative Obs and Gynae 7/e, p 173, Randhir Puri and Narendra MalhotraThis explains that a careful wait and watch policy should be adopted for occipito-posterior position.
Emergency CS
Wait and watch for progress of labor
Early rupture of membranes
Start oxytocin drip
Malpresentation