Reverse Breech Extraction vs. Vaginal Push for Cesarean Sections A Comparison of Maternal and Fetal Outcomes

Introduction

In emergency cesarean sections with a fully dilated cervix and impacted fetal head, two methods are commonly used: reverse breech extraction and vaginal push. This study evaluates the safety and efficacy of these two techniques, comparing their effects on maternal and fetal health. For further insights on advanced obstetrics research, visit https://www.obstetricgynecoljournal.com and explore more groundbreaking studies.

Main Content Sections

Emergency cesarean sections (CS) with fully dilated cervix and impacted fetal head account for a significant percentage of all CS cases. The impacted fetal head can complicate delivery and may lead to maternal and fetal morbidities. This study compares vaginal push and reverse breech extraction as methods to address these complications.

Methodology:

The study involved 152 women who underwent emergency CS at Menoufia University Hospital between 2018 and 2023. These women were divided into two groups:

• Group 1 (Vaginal Push): 96 women had the fetal head pushed vaginally before uterine incision.
• Group 2 (Reverse Breech Extraction): 56 women underwent reverse breech delivery.

Findings:

• Maternal Outcomes: Group 1 exhibited significantly higher rates of uterine incision extension, longer operative time, and greater blood loss. However, the uterotomy-to-delivery time was shorter for vaginal push.
• Fetal Outcomes: Both groups showed similar results in terms of APGAR scores and neonatal outcomes, though group 1 had a slightly higher APGAR score at 1 minute.

Conclusion:

The vaginal push technique is still the most widely used and associated with higher intraoperative morbidity, though both methods yield comparable postoperative maternal and fetal outcomes. Larger studies are needed to explore the safety of reverse breech extraction.

Integration of External Medical Sources:

The study of impacted fetal head management has been emphasized by The American College of Obstetricians and Gynecologists (ACOG), which advocates for further research and guidelines to optimize cesarean section procedures. Read more at ACOG.

Further Reading and Resources

For more detailed analysis, visit the full study at https://doi.org/10.29328/journal.cjog.1001145.

Learn more about cesarean section innovations by exploring related studies at Obstetric & Gynecology Journal.

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