{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,9,26]],"date-time":"2026-09-26T09:34:50Z","timestamp":1790415290987,"version":"4.1.0"},"reference-count":33,"publisher":"Wiley","issue":"11","license":[{"start":{"date-parts":[[2011,7,27]],"date-time":"2011-07-27T00:00:00Z","timestamp":1311724800000},"content-version":"vor","delay-in-days":0,"URL":"http:\/\/onlinelibrary.wiley.com\/termsAndConditions#vor"}],"content-domain":{"domain":["obgyn.onlinelibrary.wiley.com"],"crossmark-restriction":true},"short-container-title":["Acta Obstet Gynecol Scand"],"published-print":{"date-parts":[[2011,11]]},"abstract":"<jats:title>Abstract<\/jats:title><jats:p><jats:italic>Objective.<\/jats:italic> To examine the accuracy of abdominal palpation for identifying left\u2010occipito\u2010anterior (LOA) fetal position using abdominal ultrasound as the reference standard. <jats:italic>Design:<\/jats:italic> Classical test accuracy study undertaken in 2005\u20132007. <jats:italic>Setting:<\/jats:italic> Birmingham Women's Foundation NHS Trust serving a large, socio\u2010economically and ethnically varied population. <jats:italic>Sample.<\/jats:italic> All nulliparous women with spontaneous or induced labor before established labor (cervix &lt;4cm dilated), with a singleton live pregnancy of over 37 completed gestational weeks without known fetal abnormalities. <jats:italic>Methods.<\/jats:italic> Accuracy of abdominal palpation (index test) in identifying LOA fetal position, with abdominal ultrasound as reference. Trained observers blind to the index test results performed the ultrasound independently. <jats:italic>Main outcome measures.<\/jats:italic> Accuracy of palpation in determining LOA position. <jats:italic>Results.<\/jats:italic> Midwives\u2019 abdominal palpation and ultrasound data were obtained from 629 women. There were 61 (9%) fetuses in LOA position that were verified by ultrasound. The sensitivity and specificity of palpation to detect LOA position were 34% (95%CI 23\u201346) and 71% (67\u201374), respectively. Midwives with experience &gt;5 years achieved higher sensitivity compared to those with \u22645 years (odds ratio 4.02; 1.26\u201312.9; <jats:italic>p<\/jats:italic>=0.019). Sensitivity was higher for community compared with hospital midwives (OR 6.59; 1.11\u201339.11; <jats:italic>p<\/jats:italic>=0.038). <jats:italic>Conclusions.<\/jats:italic> Abdominal palpation to determine LOA position at the onset of labor had poor accuracy in nulliparous women on arrival at the maternity unit with a cervix dilation of &lt;4cm. If future research demonstrates that an optimal fetal position at labor onset exists, ultrasound scan to confirm fetal position on arrival for birth may improve midwives\u2019 ability to prognosticate.<\/jats:p>","DOI":"10.1111\/j.1600-0412.2011.01226.x","type":"journal-article","created":{"date-parts":[[2011,6,23]],"date-time":"2011-06-23T12:43:37Z","timestamp":1308833017000},"page":"1259-1266","update-policy":"https:\/\/doi.org\/10.1002\/crossmark_policy","source":"Crossref","is-referenced-by-count":9,"title":["Abdominal palpation to determine fetal position at labor onset: a test accuracy study"],"prefix":"10.1111","volume":"90","author":[{"given":"SARA S.","family":"WEBB","sequence":"first","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"MARIA N.","family":"PLANA","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"JAVIER","family":"ZAMORA","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"AISHAH","family":"AHMAD","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"BERNADETTE","family":"EARLEY","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"CHRISTINE","family":"MACARTHUR","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"KHALID S.","family":"KHAN","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"311","published-online":{"date-parts":[[2011,7,27]]},"reference":[{"key":"e_1_2_8_2_2","first-page":"409","volume-title":"Williams Obstetrics","author":"Cunningham FG","year":"2008"},{"key":"e_1_2_8_3_2","first-page":"208","volume-title":"Maye's Midwifery: A Textbook for Midwives","author":"Sweet B","year":"1997"},{"key":"e_1_2_8_4_2","first-page":"251","volume-title":"Myle's Textbook for Midwives","author":"Fraser D","year":"2004"},{"key":"e_1_2_8_5_2","doi-asserted-by":"publisher","DOI":"10.1097\/00006250-200112000-00007"},{"key":"e_1_2_8_6_2","first-page":"955","article-title":"Vaginal delivery from the persistent occiput posterior position. 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