Prophylactic attempt at manual rotation in brow presentation at full dilatation


  • Conflict of interest The authors have seen and approved the final manuscript and have stated explicitly that there are no conflicts of interest in connection with this article.

  • Please cite this article as: Verspyck E, Bisson V, Gromez A, Resch B, Diguet A, Marpeau L. Prophylactic attempt at manual rotation in brow presentation at full dilatation. Acta Obstet Gynecol Scand 2012; 91:1342-1345.

Professor Eric Verspyck, Clinique Gynécologique et Obstétricale, Rouen University Hospital-Charles Nicolle, 1 Rue de Germont, 76031 Rouen Cedex – France. E-mail:


We report our management of brow presentation at full dilatation by a prophylactic attempt at manual rotation or immediate cesarean delivery, depending on practitioner training. During the study period, 49 women with brow presentation were collected for an overall 30 452 deliveries (1/621) and 22 (44.9%) of them were diagnosed at full dilatation. For the latter, an attempt at manual rotation was performed in 13 cases (59.1%) with no particular maternal or neonatal complications reported and vaginal delivery occurred in 10 (76.9%). Maternal and neonatal outcomes were similar between women with immediate cesarean section or prophylactic manual rotation, except for a shorter duration of hospitalization in the group with attempted manual rotation (p < 0.01). Prophylactic attempted manual rotation in brow presentation diagnosed at full dilatation may be associated with a high rate of vaginal delivery with no specific maternal or neonatal complications.