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Article
February 13, 1926

THE MANAGEMENT OF PERSISTENT OCCIPITOPOSTERIOR POSITION: BY USE OF THE KIELLAND FORCEPS OR MANUAL RECTIFICATION

JAMA. 1926;86(7):465-467. doi:10.1001/jama.1926.02670330009003
Abstract

Great diversity of practice and teaching exists among obstetric specialists in regard to occipitoposterior position in labor. This lack of uniformity in textbooks and handbooks on obstetrics and in papers in obstetric and medical journals may account in part for the unsatisfactory management of this cause of high maternal morbidity and fetal mortality in hospital and private practice.

There should be but one definition of persistent occipitoposterior position. It is the condition that results in skull presentation from the rotation of the occiput backward toward the sacrum. This occurs only when the head enters the pelvis with the occiput more or less posterior to the transverse diameter of the pelvis. The usual or normal anterior rotation of the occiput in all presentations, including the oblique posterior, may occur at any stage of descent, even before complete dilatation of the cervix; but when the occiput is more or less posterior at

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