Comparison of neonatal and maternal outcomes associated with head-pushing and head-pulling methods for impacted fetal head extraction during cesarean delivery

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• 作者：Parvin Bastani ; Shabnam Pourabolghase ; ^{sh.pourabolghasem@gmail.com} ; Fatemeh Abbasalizadeh ; Leila Motvalli
• 关键词：Cesarean delivery ; Critical care obstetrics ; Labor management ; Pull method ; Push method
• 刊名：International Journal of Gynecology and Obstetrics
• 出版年：2012
• 期刊代码：130_00207292
• 类别：med
• 出版时间：July, 2012
• 卷：118
• 期：1
• 页码：1-3
• 文件大小：97 K

摘要

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 鈥減ush鈥?group (n = 30) and the 鈥減ull鈥?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.