OCCIPUT POSTERIOR

One of the most important criteria in the realization of the birth is the posture of the baby, its position and the part that enters the birth canal. It is found upside down in about 95% of births and the baby enters the birth canal with head up. Approximately 5% of births are located at the entrance of the birth canal with the baby's breech, feet or body horizontal.
In the majority of situations in which the baby's head is ahead, the baby's face stands facing the mother's back. So in front there is the back of the baby's head. This is considered normal head birth and is called occiput anterior.
Conversely, if the baby's face is facing the mother's abdomen, the back of the baby's head faces the mother's back, and it is called the occiput posterior (malposition).
Although the baby's head is mostly occiput anterior at the beginning of delivery, occiput posterior is also considered normal. Because as the birth progresses, the head will turn and come to the occiput anterior position.
Rarely, this rotation does not occur, and the baby's head remains in the occiput posterior position, and this is called the persipip occiput posterior. Conversely, the normal occiput anteriorly stopping head at the beginning of labor can rotate to become the occiput posterior state in the later stages of labor.
In the vaginal examination with the finger, it is understood which of these positions the baby's head is in by looking at the fontanels of the baby.
The importance of the occiput posterior posture is making delivery difficult. It causes prolonged stages of delivery and can sometimes cause interventions such as vacuum-forceps or cesarean delivery may be required. Episiotomy may be larger and large tears that sometimes extend to the rectum may occur during delivery. However, occiput posterior posture is not always a condition that requires cesarean delivery. In the occiput posterior position, babies can also be born with a normal birth, but according to the progression of the birth and the examination findings, the doctor can make a cesarean decision if necessary.
Risk factors for occiput posterior posture:
- Nulliparite (First birth)
- Obesity
- Maternal age over 35
- gestational week exceeding 41 weeks
- Baby's birth weight over 4000 g
- Having had occiput posterior delivery before
- The prolongation of the first and second stages of birth
- Epidural analgesia


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