Labour in this condition is usually longer than normal. Uterine contractions may be sufficient to 'turn' an occipitoposterior presentation at the onset of labour into an occipitoanterior presentation at delivery.
It is necessary to maintain the patient's morale and ensure that she does not become dehydrated. The patient will require sufficient analgesia, and despite the risk of causing poor levator tone and problems with rotation of the fetal head, epidural analgesia is often used. The strength of uterine contractions must be adequate and syntocinon may be required. Regular monitoring of the fetal heart and inspection of the liquor must be undertaken.
If spontaneous delivery does not occur then delivery via the use of forceps or caesarian section may be required. Note that in this condition there is an increased likelihood of the development of caput and it is incorrect to assume that because the cervix is fully dilated that the baby is ready to, and able to, be delivered vaginally.
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