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EFM Case Study #1: OP Malpresentation (1 hour Monograph)

Hours: 1.00

Best suited for: Obstetricians, family practice, midwives, obstetric nurse practitioners

Occiput posterior (OP) malpresentation occurs 15-25% at term and 5-12% at birth, increases risk of surgical birth, and frequently coincides with category II or III FHR patterns. In an effort to reduce cesarean births, non-invasive and invasive rotational measures may correct the position of the fetus. AWHONN encourages use of various birth positions for spontaneous rotation. ACOG and SMFM guidelines encourage practitioners to perform manual rotation of the fetal occiput in the setting of fetal malposition in the second stage of labor as an intervention prior to operative vaginal delivery or surgery. Our course uses three case studies to outline new management recommendations.

Original Release Date: July 30, 2015
Review Date: January 30, 2018
Expiration Date: July 30, 2018

Learning Objectives: Upon completion, participants should be able to
1. Outline the clinical implications of OP malpresentation.
2. Analyze 3 EFM case studies and compare to existing practice.
3. Review and indicate how new guidelines can be successfully incorporated into clinical

Learning Assessment: There will be a posttest for this activity with a minimum performance requirement of 8 out of 10 correct answers.

Estimated time to complete activity: 1 hour

Residents will earn a certificate of completion. Physicians will earn CME credit. 

Method and Medium: To obtain CME credit, view the entire online presentation, complete the evaluation and posttest and print your certificate online.

CME Credit: 1.0


State Requirements: Based on information from state licensing authorities published by the AMA, this program meets specific CME requirements for the following states:
Florida -  This activity includes content in Preventing Medical Errors
Connecticut - This activity includes content in Risk Management
Massachusetts - This activity includes content in Risk Management
Pennsylvania - This activity includes content in Risk Management / Patient Safety
Texas - This activity includes content in Ethics and/or Professional Responsibility

CME Information - Read

Disclosure Policy - Read

About the Authors: Carol A. Curran RNC, MS, OGNP - Read Bio & Dr. Kenneth Brown - Read Bio

Disclosure Statement: The author, expert reviewer, editors, and planning committee members for this activity have no relevant financial relationships to disclose.

Managing Editor: Dawer Azizi, MHA, CPHRM, LAMMICO Director of Risk Management

Editor: Sharon Cusanza, MSN, RN, NEA-BC, LAMMICO Senior Risk Management Education Specialist

Content Advisors/Planning Committee Members - Read

Electronic Hardware and Software Requirements - Read

Web Master Contact Information: For assistance, contact Shea Ivey at 866/398-1038 or help@medicalinteractive.com

Disclaimer: This activity is presented by LAMMICO as risk management education. It is not legal advice, nor does it establish medical standards of care. Standards of care vary depending on the unique presentation of each patient. The information contained herein is not a substitute for the reasonable discretion of skilled and informed clinicians at the point of care.

Copyright Information: Copyright © 2015
This course contains some pictures that were reprinted with permission from McGraw-Hill Education. McGraw-Hill makes no representations or warranties as to the accuracy of any information contained in the McGraw-Hill material, including any warranties of merchantability or fitness for a particular purpose. In no event shall McGraw-Hill have any liability to any party for special, incidental, tort, or consequential damages arising out of or in connection with the McGraw-Hill material, even if McGraw-Hill has been advised of the possibility of such damages.

Bibliography: To view and download References & Resources for this presentation, please select the References button below.

Member and Subscriber Access
Interested in a CME program like this for your team or facility? Contact us to schedule it and talk about pricing.

This course is offered through Experix, a wholly owned subsidiary of Physicians Insurance, and is based on more than 30 years' experience in providing continuing medical education. This course is complimentary for Physicians Insurance members.

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