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At delivery occipitoposterior it is known colloquially as 'kidney delivery'. It is the most frequent of the malpositions in the babies who are in cephalic position. In it, the head of the baby in the birth canal, characterized by the posterior part of it is located towards the sacrum or towards the most posterior part of the pelvis.
By preventing the normal process of flexion of the pelvis, in occipitoposterior delivery, the period of dilation is lengthened and this makes vaginal delivery difficult. And these types of deliveries can be much longer and tiring than normal vaginal deliveries, and with much more lumbar pain than the occipital-anterior position (the back of the baby's head is located towards the symphysis pubis or anterior half of the pelvis).
The sensation of pushing can be very early, long before the expulsive period, due to the overstimulation produced by this malposition on the sacral nerves. Due to this characteristic discomfort in the lower back in these deliveries, they are colloquially also known as 'kidney deliveries'.
The occipitoposterior position at the time of delivery is related to:
- Greater need to use oxytocin
- Higher incidence of infection
- More instrumental deliveries and cesarean sections
- More risk of major tears.
Regarding the newborn, it is related to lower scores in the Apgar test, lower pH values at birth, higher number of admissions to neonatology and higher number of obstetric trauma - related to the increase in instrumental deliveries in this type of presentation -.
This type of kidney delivery is much more common in women who have not had any previous childbirth. In addition, epidural analgesia placed in an early phase of labor favors the appearance of this presentation, due to its effects on the pelvic floor and uterine dynamics, among other characteristics.
Also the characteristics of our current life, more sedentary, in which most women do their work sitting down and do not practice enough sport (it is estimated that 70% of the Spanish population does not do the amount of physical activity recommended to maintain Health) . In addition to these, the size of the mother and the type of pelvis, history of other deliveries with fetuses that present this same bad position, babies with an estimated weight above 4000 grams or too small (below 2500 grams) are considered.
On the other hand, the mobility of the pregnant woman during labor and the positions adopted, such as positions on hands and knees (boxpenia) favor the normal position of the baby and the good progression of labor.
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