The role of manual rotation in avoiding and managing OVD

Stephen O'Brien*, Sharon Jordan, Dimitrios Siassakos

*Corresponding author for this work

Research output: Contribution to journalReview article (Academic Journal)peer-review

2 Citations (Scopus)
313 Downloads (Pure)


Manual rotation (MR) is the most common technique used by accoucheurs who wish to correct malposition of the foetal head to either avoid or facilitate an operative vaginal delivery (OVD). MR can be performed using either a whole-hand or a digital approach. MR should be formally taught and trainees should be assessed for competence, and later, performance should ideally be tracked with statistical control charts. There is paucity of robust evidence evaluating MR relative to the other methods of rotational OVD: rotational forceps (RF) and rotational ventouse (RV). Furthermore, there is little evidence concerning long-term maternal outcomes of rotational OVD. A prospective randomised trial of MR versus either RF or RV is clearly needed, along with a core outcome set for OVD to facilitate comprehensive evaluation programmes that focus on aspects pertaining to women.

Original languageEnglish
Pages (from-to)69-80
Number of pages12
JournalBest Practice and Research: Clinical Obstetrics and Gynaecology
Publication statusPublished - 1 Apr 2019


  • Birth
  • Manual rotation
  • Rotational birth


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