This is the most common malposition. The head is usually incompletely flexed and the occipitofrontal diameter presents - ie a larger diameter is involved.
Approximately 10% of labours begin this way, but many correct in labour. The shape of the pelvis, the strength of contractions and thus the presence of an epidural all influence this correction.
From LOP 65% rotate to OA, 15% rotate to OP and are delivered as "face to pubes" - this is more difficult due to the increased diameter - and 20% rotate to OT, which is incompatible with normal delivery. In this last case the management depends on the stage of labour - 5cm dilation of the cervix indicates the need for a caesarian section, full dilation might be managed with forceps (Kielland or Ventouse).
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