HEAD PUSHING VERSUS REVERSE BREECH EXTRACTION FOR DELIVERY OF IMPACTED FETAL HEAD DURING CAESAREAN SECTION

Alshikha Haya Ahmad Diab*, Sahar Hassan, Ahmad Ali Abdulrahman and Jihad Mostafa Alayoub

ABSTRACT

The cesarean rate in developed countries has reached 31.1%, extracting the impacted head during cesarean section poses a major challenge to obstetricians in the presence of an overlap Bones of the head and edema, in addition to the fact that the lower part of the uterus is greatly stretched and thinned, so such cases are usually accompanied by many maternal complications, including: extension of the uterine fissure, increased incidence of bleeding and the need for blood transfusion, prolonged surgical period, increased risk of infections after surgery, urinary tract injuries such as the injury of the bladder. The study sample include 60 full-term pregnant postpartum patients admitted to the labor department between 2023 and 2024 who met the criteria for inclusion in the study and agreed to enter it after explaining its purpose and method. The results showed that 30 patients were accepted for each of the two study groups who met the entry criteria (30 patients for the transvaginal push group and 30 patients for the reverse breech extraction group). The incidence of extension of the uterine incision was higher in the transvaginal thrust group, where the difference was statistically significant, p<0.05, in addition to the incidence of urinary complications during surgery at a higher rate in the transvaginal head thrust group, with a statistical difference of <0.05, p. No significant differences were observed between the two groups in terms of surgical time, bleeding, and postoperative infections, as the differences were not statistically significant between the two groups, p≥0.05.

Keywords: Second stage of labor, reserve breech extraction, head-pushing method, cesarean section, impacted fetal head.