Main author (year) country

Aim of study


of study


Shaffer (2006)


To define predictors of successful rotation and rate of caesarean delivery after manual rotation of the foetal occiput from occiput posterior or transverse position

Retrospective cohort study

742 women met the criteria during the study period

Reichman (2008) Israel

To study the efficacy of DR in reducing the

prevalence of POP positions and its consequences



Group 1: without intervention, 30 women Group 2: DR or MR, 31 women

Shaffer (2011)USA

To examine mode of delivery and perinatal

outcomes in women with OP or OT position in the second stage of labour with a trial of MR compared to expectant management

Retrospective cohort study

Group1: MR 731 women Group2: Expectant management: 2527 POP or OT positions diagnosed at delivery

Le Ray (2013) France

To assess the effect of a policy of MR on the mode of delivery of foetuses in OP or OT positions at full dilatation



Hospital 1: No MR 111 women Hospital 2: MR 220 women

Sen (2013) Japan

To examine the risk factors and management processes of the POP position by analyzing medical records from one hospital.

Retrospective study

OP positions in labour: 103 MR: 17 Posture change: 13 The rest: no management Control group: 1054 OA positions

Graham (2014) Australia

To determine the feasibility of a multicentre RCT to investigate whether DR of the foetal head from OP position in the second stage of labour reduces the risk of OD

Pilot study

1004 women consented. Randomised: 30; DR: 15 Sham procedure: 15

Le Ray (2007)


To identify the risk factors for failure of MR in

patients with OP or OT positions during labour and to study the caesarean rate in relation to the success of the rotation

Case-control study

MR performed on 796 women. After randomization: 79 successful MR, 68 failed MR