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All subscribers to ACOG UPDATE audio CDs will also have free access and ability to download the same program in MP3 format. They can also download a PDF file of the complete transcript with Pre- and Post-test Questions and a List of Supplementary Reading Materials.

Volume 41, Issue 4
Publication date: October 1, 2015
Expiration date: October 1, 2018

Prevention & Management of Persistent Occiput Posterior
William H. Barth Jr, MD (Moderator)
Associate Professor of Obstetrics, Gynecology, and Reproductive Biology, Harvard Medical School; Chief, Division of Maternal-Fetal Medicine, Massachusetts General Hospital/Vincent Obstetrics and Gynecology Service, Boston, Massachusetts

James A. Greenberg, MD
Associate Professor of Obstetrics, Gynecology, and Reproductive Biology, Harvard Medical School; Chief, Division of Gynecology, Brigham and Women’s Faulkner Hospital, Boston, Massachusetts

Julian N. Robinson, MD
Associate Professor of Obstetrics, Gynecology, and Reproductive Biology, Harvard Medical School; Chief of Obstetrics, Division of Maternal-Fetal Medicine, Brigham and Women’s Hospital, Boston, Massachusetts

Learning Objectives
After completing this activity, the physician should be better able to:
1. Describe the role of ultrasound in the detection of occiput posterior (OP).
2. Identify options for the management of OP depending on when it is encountered in labor.
3. Prevent 3rd- and 4th-degree lacerations associated with persistent OP.
4. Minimize extensions of the hysterotomy incision during a cesarean delivery when delivering a deeply impacted fetal head.
5. Discuss the challenges to contemporary training in operative vaginal delivery.


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