Jury still out on manual rotation for occiput transverse fetuses

The world's first randomised controlled trial on the subject had to be abandoned, the Australian researchers report
Clare Pain
woman in labour with healthcare worker

Results from the first trial to examine whether manual rotation reduces the need for operative delivery in women with a fetus in the occiput transverse (OT) position show no benefit over a sham procedure.

But recruitment for the trial was slow, and then funding ran out, with the result that only 160 women took part rather than the 400 specified in the trial protocol, reported the researchers led by obstetrician Dr Bradley De Vries, of the University of Sydney and Royal Prince Alfred Hospital.

The TURN-OUT (Transverse position Using Rotation to aid Normal birth – OUTcomes following manual rotation) trial was carried out at three Australian hospitals between 2012 and 2018, they wrote in the American Journal of Obstetrics and Gynecology.

Women eligible for enrolment were aged 18 years and over with a singleton, term, cephalic-presenting pregnancy who were planning a vaginal birth and were found to have fetal OT position on bedside transabdominal ultrasound in the second stage of labour just prior to planned intervention.