Head pushing versus reverse breech extraction for delivery of impacted fetal head during caesarean section

الملخص EN

Obstructed labor is a serious obstetric complication associated with poor fetal and maternal outcome.

Delivery of the fetus at caesarean section is almost always difficult especially if the fetal head is impacted in the pelvis. The purpose of this study was to examine and compare maternal and fetal morbidity associated with two method of delivery of impacted fetal head during caesarian section for obstructed labor: the push method and the reverse breech extraction (pull) method. This study was conducted at Al-Zahraa Maternity and Pediatric Teaching Hospital in Al- Najaf during period between 1st February to 1st September -2006 .

This study is prospective study include 50 pregnant women with difficult extraction of the impacted fetal head during caesarean section divided into 2 groups according to the method of delivery of the fetal head- push method or reverse breech (pulling) method. The study compared the maternal morbidity as assessed by extension of the uterine incision, damage of a visceral organ, intra and postoperative blood transfusion, postpartum hemorrhage, wound infection and duration of hospital stay. Neonatal morbidity was assessed by Apgar score and admission to neonatal intensive care unit.

Maternal complications were found to be less with pulling method than pushing also neonatal outcome found to be better with pulling method