Cesarean Breech Extraction For Impacted Fetal Head In Deep Pelvis After A Prolonged Obstructed Labour: A Cesarean Technique Variation

10.5580/1f1 ◽  
2003 ◽  
Vol 2 (2) ◽  
Keyword(s):  
Fetal Head ◽  
Obstructed Labour ◽  
Breech Extraction

scholarly journals Between Scylla and Charybdis: renegotiating resolution of the ‘obstetric dilemma’ in response to ecological change

2015 ◽  
Vol 370 (1663) ◽  
pp. 20140067 ◽  
Author(s):  
Jonathan C. K. Wells
Keyword(s):  
Ecological Change ◽  
Perinatal Morbidity ◽  
Short Term ◽  
Fetal Head ◽  
Maternal Size ◽  
Obstructed Labour ◽  
Hominin Evolution ◽  
Rapid Changes ◽  
Pass Through ◽  
Key Questions

Hominin evolution saw the emergence of two traits—bipedality and encephalization—that are fundamentally linked because the fetal head must pass through the maternal pelvis at birth, a scenario termed the ‘obstetric dilemma’. While adaptive explanations for bipedality and large brains address adult phenotype, it is brain and pelvic growth that are subject to the obstetric dilemma. Many contemporary populations experience substantial maternal and perinatal morbidity/mortality from obstructed labour, yet there is increasing recognition that the obstetric dilemma is not fixed and is affected by ecological change. Ecological trends may affect growth of the pelvis and offspring brain to different extents, while the two traits also differ by a generation in the timing of their exposure. Two key questions arise: how can the fit between the maternal pelvis and the offspring brain be ‘renegotiated’ as the environment changes, and what nutritional signals regulate this process? I argue that the potential for maternal size to change across generations precludes birthweight being under strong genetic influence. Instead, fetal growth tracks maternal phenotype, which buffers short-term ecological perturbations. Nevertheless, rapid changes in nutritional supply between generations can generate antagonistic influences on maternal and offspring traits, increasing the risk of obstructed labour.

Disengagement of the deeply engaged fetal head during cesarean section in advanced labor: Conventional method versus reverse breech extraction

2009 ◽  
Vol 88 (10) ◽  
pp. 1163-1166 ◽  
Author(s):  
Seema Chopra ◽  
Rashmi Bagga ◽  
Anish Keepanasseril ◽  
Vanita Jain ◽  
Jasvinder Kalra ◽  
...  
Keyword(s):  
Cesarean Section ◽  
Conventional Method ◽  
Fetal Head ◽  
Breech Extraction

Simulation of an impacted fetal head extraction during cesarean section: description of the creation and evaluation of a new training program

2019 ◽  
Vol 47 (8) ◽  
pp. 857-866
Author(s):  
Cécile Monod ◽  
Johanna Buechel ◽  
Stefan Gisin ◽  
Aisha Abo El Ela ◽  
Deborah R. Vogt ◽  
...  
Keyword(s):  
Cesarean Section ◽  
Training Program ◽  
Clinical Work ◽  
Likert Scale ◽  
Rank Test ◽  
Fetal Head ◽  
Simulation Based ◽  
Post Test ◽  
Signed Rank Test ◽  
Breech Extraction

Abstract Background Although cesarean sections at full dilatation are increasing, training in delivering a deeply impacted fetal head is lacking among obstetricians. The purpose of the study was to implement and evaluate a theoretical and simulation-based training program for this obstetrical emergency. Methods We developed a training program consisting of a theoretical introduction presenting a clinical algorithm, developed on the basis of the available literature, followed by a simulation session. We used the Kirkpatrick’s framework to evaluate the program. A questionnaire was distributed, directly before, immediately and 6 weeks after the training. Self-perceived competencies were evaluated on a 6-point Likert scale. Pre- and post-test differences in the Likert scale were measured with the Wilcoxon signed rank test. Additionally, the training sessions were video recorded and rated with a checklist in relation to how well the algorithm was followed. Results Eleven residents and eight senior physicians took part to the training. More than 40% of participants experienced a comparable situation after the course during clinical work. Their knowledge and self-perceived competencies improved immediately after the training program and 6 weeks later. Major improvements were seen in the awareness of the algorithm and in the confidence in performing the reverse breech extraction (14.3% of the participants felt confident with the maneuver in the pre-training assessment compared with 66.7% 6 week post-training). Conclusion Our theoretical and simulation-based training program was successful in improving knowledge and confidence of the participants in delivering a deeply impacted fetal head during a cesarean section performed at full dilation.

scholarly journals Bladder stone: a rare cause of obstructed labour

2017 ◽  
Vol 4 (7) ◽  
pp. 2352
Author(s):  
Mangala Sonak ◽  
Sangeeta Ramteke ◽  
Medha Davile
Keyword(s):  
Caesarean Section ◽  
Postoperative Period ◽  
Vesicovaginal Fistula ◽  
Bladder Stone ◽  
Common Phenomenon ◽  
Fetal Head ◽  
Vesical Calculus ◽  
Obstructed Labour ◽  
Study Report ◽  
Prompt Diagnosis

Bladder stone is a rare cause of obstructed labour. Study report a case of bladder stone obstructing the labour in a multipara. Diagnosis was made during labour on pervaginal examination. The stone was impacted below the fetal head thus obstructing labour. A bladder stone weighing approximately 120 g and measuring 6x6 cm was removed by cystolithotomy at the time of caesarean section. The postoperative period was uneventful. Mechanical cause resulting in obstructed labour is a very common phenomenon but vesical calculus causing dystocia is very rare and till date very few cases of vesical calculus resulting in obstructed labour has been reported in the literature. Prompt diagnosis of the condition is very important to prevent grave complications like vesicovaginal fistula and rupture uterus.

scholarly journals Bladder stone: still a rare cause of obstructed labour

2012 ◽  
Vol 26 (1) ◽  
pp. 1
Author(s):  
Sonika Mann ◽  
Amit Mann ◽  
Pushpa Dahiya ◽  
Krishna Dahiya
Keyword(s):  
Cesarean Section ◽  
Postoperative Period ◽  
Rare Case ◽  
Bladder Stone ◽  
Fetal Head ◽  
Obstructed Labour

Bladder stone is still a rare cause of obstetrical dystocia. We report a rare case of obstructed labour due to a huge bladder stone. Diagnosis was confirmed only at the time of cesarean section because of the unusual posterolateral location of the stone, which was impacted below the fetal head thus obstructing labour. A bladder stone weighing 140 g and measuring 9×6×5 cm3 was removed by cystolithotomy at the time of cesarean section. The postoperative period was uneventful.

scholarly journals REVERSE BREECH EXTRACTION AT CESAREAN SECTION IN SECOND STAGE OF LABOR

2020 ◽  
Vol 73 (5) ◽  
pp. 1028-1031
Author(s):  
Leonid B. Markin ◽  
Olena S. Rachkevych ◽  
Olena M. Zhemela
Keyword(s):  
Cesarean Section ◽  
Biomedical Data ◽  
Maternal Complications ◽  
Fetal Head ◽  
Surgical Interventions ◽  
Safe Delivery ◽  
Second Stage Of Labor ◽  
Second Stage ◽  
Delivery Technique ◽  
Breech Extraction

The aim: Taking into consideration the increase in the frequency of urgent C-sections in the second stage of labor and significant technical difficulties in the extraction of deeply impacted fetal head during this operation, the aim of our work was to analyze the current published biomedical data to identify the optimal technical strategies for conducting this type of surgical interventions. Materials and methods: The search and analysis of current clinical data available in PubMed was performed. We analyzed 9 retrospective and randomized prospective studies with collected data from a total of 974 women (2002-2019). Conclusions: Analysis of nine prospective and retrospective studies, comparing reverse breech extraction with abdominovaginal technique, revealed a significant advantage and safety of reverse breech extraction. This procedure has been associated with the decrease of traumatic uncontrolled extension of uterine incisions in 2.3-10 times, the time of surgical intervention decreased by 6.5-33 minutes, and intraoperative blood loss was less by 149.5-444 ml as compared with abdominovaginal delivery. Moreover, less intra- and postoperative complications were observed. In conclusion, reverse breech extraction during cesarean section with impacted fetal head is a safe delivery technique that helps to significantly decrease the incidence of maternal complications.

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