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Background: To compare the maternal and neonatal morbidities between the “Patwardhan” technique, reverse breech and the vertex extraction (Push method) of the foetus in second stage caesarean sections. Methods: A Retrospective study was done at Department of Obstetrics and Gynaecology, Bebe Nanki Mother and Child Care Center, Government College, Amritsar, Punjab, India from year 2013 to 2016 (three and half years). Women with full term pregnancy with fetus in vertex position and the head deeply impacted in pelvis and needing caesarean delivery were included in the study. Group-A consists of all cases in which extraction of foetus was done by Patwardhan technique as well as reverse breech extraction. Group-B consists of cases in whom extraction of foetus was done by push up method and extracted as vertex. Objective of the study was to assess selective complications like extension of the incision, injury to the surrounding structures, excessive bleeding, need for blood transfusion and the foetal outcome between the two groups. Results:- Out of 100 cases reviewed, 55 belonged to group A (Patwardhan and reverse breech extraction) and 45 belonged to group B (vertex extraction). Patients in the group B had statistically significant higher rates of maternal morbidity in terms of uterine extension and other related complications. However; there were no differences in neonatal outcomes in both the groups. Conclusions: While complications are inherent in methods, Patwardhan method and reverse breech extraction of delivery of the foetus for second stage labour has been shown to confer considerable advantage in prevention of maternal morbidity over the push method in our institution. Our findings support the fact that the Patwardhan method and reverse breech extraction could be a useful manoeuvre in intraoperative disengagement of foetal head, when encountered at second stage CS and it is our opinion that these techniques can be practiced selectively as a primary technique.

Impact of Surgical Techniques in Maternal Morbidity and Foetal Outcome in Obstructed Labour: A Retrospective Study of 100 Cases of Obstructed Labour.