The active management of prolonged labor.

There has been growing concern in the medical community about the rising rate of cesarean sections. Use of the modified manual rotation technique on the arrested fetal head has resulted in a decrease in the number of sections, length of hospital stay, and, consequently, the cost of care.No longer is it necessary to operate on every woman who comes to the end of the second stage of labor in the persistent occiput posterior or transverse arrest position. This technique also helps to reduce, if not eliminate, the more difficult and traumatic midforcep rotations and extractions.