How to rotate from right occiput posterior position to occiput anterior position

Feb 22, 2023 Source: Cainiu Health

Dr. Lin Yunfei

Introduction

Right occiput posterior position can generally be corrected to an occiput anterior position by sleeping on the left side, performing the knee-chest position, and applying external cephalic version. Right occiput posterior position is usually a form of malpresentation. To correct abnormal fetal position before the fetus engages in the pelvis, in addition to the above methods, the occiput posterior position can also be improved by adopting跪姿 (kneeling postures) and standing positions, which can alter the shape of the pelvis and provide space for the fetus to rotate.

Right occiput posterior position can generally be corrected to occiput anterior position through methods such as sleeping on the left side, knee-chest position, and external cephalic version.

1. Sleeping on the Left Side

Right occiput posterior position is usually due to abnormal fetal presentation. To correct malposition before the fetus engages in the pelvis, sleeping on the left side may help. Adopting a left lateral decubitus position during sleep increases maternal cardiac output and improves blood flow, thereby providing adequate nutrients and oxygen to the fetus, which may encourage the fetus to rotate into the occiput anterior position.

2. Knee-Chest Position

Pregnant women can also improve fetal positioning by assuming the knee-chest position. This involves getting on all fours with knees placed on the bed, placing a pillow under the chest, bending the arms, resting the head sideways on the bed, and positioning the thighs and hips at a 90-degree angle. Maintaining this posture for a period of time may help the fetus rotate into the anterior position.

3. External Cephalic Version

If the occiput posterior position persists and does not naturally shift to occiput anterior, external cephalic version can be performed under medical supervision. This procedure uses manual pressure on the abdomen to guide the fetus into the correct (anterior) position, effectively correcting the fetal presentation.

In addition, occiput posterior position may also be improved by adopting positions such as kneeling or standing, which can alter the shape of the pelvis and create more space for the fetus to rotate.

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At 37 weeks, can the fetal position change from LOP to LOA?

At 37 weeks, fetal position LOP usually adjusts to LOA. LOP refers to left occiput posterior position, while LOA refers to left occiput anterior position. Both positions are considered normal before labor; however, the occiput posterior position is not the ideal position for passing through the pelvis. During labor, the fetal head gradually descends under the pressure of uterine contractions and typically rotates to the LOA position, or may be manually rotated by an obstetrician.