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Abstract
Fetal head occiput posterior position (OPP) which is found in about 25% early in labor and 5% of deliveries, unlike the anterior occiput position which counts 90% of vertex presentation, involves different labor and delivery managements (Malvasi et al., 2014). Due to a higher incidence of physical and psychological traumas associated with OP, maternal and neonatal outcomes are worse because of increased rates of emergency Cesarean section, instrumental delivery, perinatal morbidity, maternal perineal lacerations and anal sphincter injuries (Adam et al., 2014). In classical literature the majority of OPP (about 90% of cases) are considered to be subsequent to a mal-rotation from an anterior or transverse position, rather than persistence of an initial OPP (Cunningham Williams Obstetrics, 2009)