Is epidural analgesia a risk factor for occiput posterior or transverse positions during labour?
OBJECTIVE: The aim of this study was to assess whether the station of the fetal head at epidural placement is associated with the risk of malposition during labour. STUDY DESIGN: Retrospective study (covering a 3-month period) of patients in labour with singleton cephalic term fetuses and epidural placement before 5 cm of dilatation. We studied the following risk factors for malposition: station and cervical dilatation at epidural placement, induction of labour, parity and macrosomia. Malposition, defined as all occiput posterior and occiput transverse positions, was assessed at 5 cm of dilatation because of our policy of systematic manual rotation for malpositions. RESULTS: The study included 398 patients, 200 of whom had malpositions diagnosed at 5 cm of dilatation. In both the univariate and multivariate analyses, station at epidural placement was the only risk factor significantly associated with this malposition (adjusted OR: 2.49, 95% CI 1.47-4.24). None of the other factors stud
