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Manual rotation (OP / OT)

Rotate the occiput anterior at full dilatation.

Source: MDedge · observational evidence

Steps

  1. Full dilatation, empty bladder, good analgesia.
  2. For LOP: right hand palm-up, fingers under posterior parietal bone, thumb on anterior.
  3. Flex the head, then rotate the occiput anteriorly with a contraction.
  4. Hold through a few pushes so it does not rotate back.
A summary for trained clinicians. Always check the full guideline, the patient in front of you and your hospital's protocol. Spotted an error? Tell us.