Management of deeply engaged and floating fetal presentations at cesarean delivery
- James Greenberg, MD
James Greenberg, MD
- Associate Professor of Obstetrics, Gynecology and Reproductive Biology
- Harvard Medical School
Fetal extraction is difficult in 1 to 2 percent of cesarean deliveries . Causes include:
●Impacted fetal head
●Floating fetal head
●Extremely low birth weight fetus
●Breech or transverse fetal lie
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- GENERAL PRINCIPLES
- DEEPLY ENGAGED FETAL HEAD
- Reverse breech extraction ("pull method")
- Abdominovaginal delivery ("push method")
- Fetal head elevator, obstetrical spoon
- - Obstetrical spoons
- - Fetal head elevators
- Shoulders first techniques
- Vacuum extraction
- UNENGAGED, FLOATING FETAL HEAD
- Internal podalic version
- Extraction with vacuum, obstetrical spoon, or forceps
- SUMMARY AND RECOMMENDATIONS