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Comparison of neonatal and maternal outcomes associated with head‐pushing and head‐pulling methods for impacted fetal head extraction during cesarean delivery
Author(s) -
Bastani Parvin,
Pourabolghase Shabnam,
Abbasalizadeh Fatemeh,
Motvalli Leila
Publication year - 2012
Publication title -
international journal of gynecology and obstetrics
Language(s) - English
Resource type - Journals
SCImago Journal Rank - 0.895
H-Index - 97
eISSN - 1879-3479
pISSN - 0020-7292
DOI - 10.1016/j.ijgo.2012.03.005
Subject(s) - medicine , fetal head , urinary system , cesarean delivery , fetus , surgery , blood loss , obstetrics , pregnancy , genetics , biology
Objective To compare the morbidity and mortality of 2 current techniques during cesarean delivery of an impacted fetal head. Methods In a comparative setting, 59 pregnant women with obstructed labor due to impacted fetal head were recruited. The patients were categorized into 2 groups according to method of extraction: the “push” group (n = 30) and the “pull” group (n = 29). Uterus relaxants were used before cesarean in all cases and the incision was higher and wider than routine. Maternal and neonatal morbidities were compared between the groups. Results Maternal complications in the push and pull groups were extension of the uterine incision (15 [50.0%] vs 5 [17.2%]); T or J incision (3 [10.0%] vs 4 [13.8%]); blood transfusion (3 [10.0%] vs 1 [3.4%]); wound infection (4 [13.3%] vs 1 [3.4%]); fever (16 [53.3%] vs 3 [10.3%]); and urinary tract infection (10 [33.3%] vs 0 [0.0%]). Incidences of extension of the uterine incision, fever, and urinary tract infection were significantly higher in the push group ( P = 0.008). Conclusion Owing to a lower rate of abnormal incision and postpartum fever/infection with the pull method, this technique is preferable to the push method.