OP Babies

[nurse79]

Hi all..

I'm still pretty new to OB..just curious, are there any tricks of the trade to tell if you have an OP baby. I know the landmarks( fontanelles) are obviously the best way but I still find it hard at times. Ive had an OP baby before without the pt having back labor, so was just curious?? thanks guys!!

[nursejohio, ASN, RN]

Sometimes you can tell by leopolds or just looking at the belly. You should be able to find the babys rump at the top of the fundus and follow the back down to the pubic bone. If it's OP, you can't really find the back, just bumps from knees and elbows. Depending on how fluffy mom is, you can often see a difference in the shape of moms belly too. With an OA baby, the back usually gives a smooth round shape. OP kids sometimes make the belly 'dip' in the middle. If you try to visualize how the baby is curled up in both positions, that will make more sense, it's hard to explain.

It's still not an exact science, and babys can flip from OP to OA during labor. I had one go from OA (per u/s) to face presentation... freaked me out just a lil when I stuck my finger in her mouth while I was checking mom.

[CMCRN]

I find if they get an anterior lip they often turn out to be OP but hard to tell from fontanells or sutures usually as too moulded. When in doubt it never hurts to have them labor in the right or left lateral sims position.

[htrn]

Many of these moms will have terrible back labor also. I have also heard a doc say that if she has a vacume pop-off during 2nd stage with no fetal decent, she quits with the vacume as it is probably OP.

[nurse79]

thanks..just curious bc i did have a pt withOUT back labor and baby was OP ,so the doc actually manually rotated babe to OA (due to distress the babe was already in). it worked, vacuum applied x2 then babe was out.