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Extracted from Survival Guide to Midwifery, 2nd Edition (2012) Diane M. Fraser and Margaret A. Cooper, Oxford; Churchill Livingstone: 2012. Courtesy Elsevier
Comparison of abdominal contour in (A) posterior and (B) anterior positions of the occiput
Occipitoposterior positions are the most common type of malposition of the occiput and occur in approximately 10 per cent of labours. A persistent occipitoposterior position results from a failure of internal rotation prior to delivery. The vertex is presenting but the occiput lies in the posterior rather than anterior part of the pelvis. As a result, the fetal head is deflexed and larger diameters of the fetal skull present. Labour with a fetus in an occipitoposterior position may be long and painful, and there is an increased risk of operative delivery.
Royal College of Midwives (2012) Evidence Based Guidelines for Midwifery-Led Care in Labour: Persistent Lateral and Posterior Fetal Positions at the Onset of Labour. https://www.rcm.org.uk/sites/default/files/Persistent%20Lateral%20and%20Posterior%20Fetal%20Positions%20%20at%20the%20Onset%20of%20Labour.pdf