Open AccessDisengagement of the deeply engaged fetal head during cesarean section in advanced labor: Conventional method versus reverse breech extraction
Author(s) -
CHOPRA SEEMA,
BAGGA RASHMI,
KEEPANASSERIL ANISH,
JAIN VANITA,
KALRA JASVINDER,
SURI VANITA
Publication year - 2009
Publication title -
acta obstetricia et gynecologica scandinavica
Language(s) - English
Resource type - Journals
SCImago Journal Rank - 1.401
H-Index - 102
eISSN - 1600-0412
pISSN - 0001-6349
DOI - 10.1080/00016340903214932
Subject(s) - medicine , breech presentation , fetal head , obstetrics , fetus , fetal position , gynecology , pregnancy , genetics , biology
Maternal and fetal morbidity of two different methods of delivering the baby during cesarean section performed in advanced labor when the fetal head is deeply engaged was assessed retrospectively, i.e. delivering as ‘cephalic’ with or without assistance to push up the fetal head from the vagina (head first or push method) and ‘reverse breech extraction’ (feet first or pull method). Records of 182 women with a single fetus in cephalic presentation, who had undergone cesarean section at cervical dilatation at ≥7 cm, with the vertex at or below zero station, were reviewed. Extension of the uterine incision occurred in significantly more women during ‘cephalic’ delivery as compared to ‘reverse breech extraction’ (22.8% versus 2.2%; p = 0.001). Use of ‘reverse breech extraction’ is an attractive and safe alternative to the standard methods for intra‐operative disengagement of a deeply impacted fetal head in order to reduce maternal and fetal morbidity.