UpToDate
Official reprint from UpToDate®
www.uptodate.com ©2015 UpToDate®

Management of deeply engaged and floating fetal presentations at cesarean delivery

Author
James Greenberg, MD
Section Editor
Susan M Ramin, MD
Deputy Editor
Vanessa A Barss, MD, FACOG

INTRODUCTION

Fetal extraction is difficult in 1 to 2 percent of cesarean deliveries [1]. Causes include:

Impacted fetal head

Floating fetal head

Extremely low birth weight fetus

Breech or transverse fetal lie

           

Subscribers log in here

To continue reading this article, you must log in with your personal, hospital, or group practice subscription. For more information or to purchase a personal subscription, click below on the option that best describes you:
Literature review current through: Aug 2015. | This topic last updated: Feb 26, 2015.
The content on the UpToDate website is not intended nor recommended as a substitute for medical advice, diagnosis, or treatment. Always seek the advice of your own physician or other qualified health care professional regarding any medical questions or conditions. The use of this website is governed by the UpToDate Terms of Use ©2015 UpToDate, Inc.
References
Top
  1. Levy R, Chernomoretz T, Appelman Z, et al. Head pushing versus reverse breech extraction in cases of impacted fetal head during Cesarean section. Eur J Obstet Gynecol Reprod Biol 2005; 121:24.
  2. Blickstein I. Difficult delivery of the impacted fetal head during cesarean section: intraoperative disengagement dystocia. J Perinat Med 2004; 32:465.
  3. Dufour P, Vinatier D, Puech F. The use of intravenous nitroglycerin for cervico-uterine relaxation: a review of the literature. Arch Gynecol Obstet 1997; 261:1.
  4. Axemo P, Fu X, Lindberg B, et al. Intravenous nitroglycerin for rapid uterine relaxation. Acta Obstet Gynecol Scand 1998; 77:50.
  5. O'Grady JP, Parker RK, Patel SS. Nitroglycerin for rapid tocolysis: development of a protocol and a literature review. J Perinatol 2000; 20:27.
  6. Sung JF, Daniels KI, Brodzinsky L, et al. Cesarean delivery outcomes after a prolonged second stage of labor. Am J Obstet Gynecol 2007; 197:306.e1.
  7. Fong YF, Arulkumaran S. Breech extraction--an alternative method of delivering a deeply engaged head at cesarean section. Int J Gynaecol Obstet 1997; 56:183.
  8. Berhan Y, Berhan A. A meta-analysis of reverse breech extraction to deliver a deeply impacted head during cesarean delivery. Int J Gynaecol Obstet 2014; 124:99.
  9. Landesman R, Graber EA. Abdominovaginal delivery: modification of the cesarean section operation to facilitate delivery of the impacted head. Am J Obstet Gynecol 1984; 148:707.
  10. Lippert TH. Abdominovaginal delivery in case of impacted head in cesarean section operation. Am J Obstet Gynecol 1985; 151:703.
  11. Lippert TH. Bimanual delivery of the fetal head at cesarean section with the fetal head in midcavity. Arch Gynecol 1983; 234:59.
  12. Fasubaa OB, Ezechi OC, Orji EO, et al. Delivery of the impacted head of the fetus at caesarean section after prolonged obstructed labour: a randomised comparative study of two methods. J Obstet Gynaecol 2002; 22:375.
  13. Tan EK. Difficult caesarean delivery of an impacted head and neonatal skull fracture: can the morbidity be avoided? J Obstet Gynaecol 2007; 27:427.
  14. WEISMAN AI, CARRABBA SR. Experiences with the Murless head extractor in cesarean section. J Am Med Assoc 1952; 150:1209.
  15. Mukhopadhyay P, Naskar T, Dalui R. Evaluation of Patwardhan’s technic - a four year study in a rural teaching hospital. J Obstet Gynecol India 2005; 55:244.
  16. Chopra S, Bagga R, Keepanasseril A, et al. Disengagement of the deeply engaged fetal head during cesarean section in advanced labor: conventional method versus reverse breech extraction. Acta Obstet Gynecol Scand 2009; 88:1163.
  17. Khosla AH, Dahiya K, Sangwan K. Cesarean section in a wedged head. Indian J Med Sci 2003; 57:187.
  18. Apuzzio JJ, Salamon C. Cesarean section. In: Operative obstetrics, 3rd ed, Apuzzio JJ, Vintzileos AM, Iffy L (Eds), Francis & Taylor Books, Co, London 2006. p.356.
  19. Pelosi MA, Apuzzio J. Use of the soft, silicone obstetric vacuum cup for delivery of the fetal head at cesarean section. J Reprod Med 1984; 29:289.
  20. Clark SL, Vines VL, Belfort MA. Fetal injury associated with routine vacuum use during cesarean delivery. Am J Obstet Gynecol 2008; 198:e4.
  21. Fareeduddin R, Schifrin BS. Subgaleal hemorrhage after the use of a vacuum extractor during elective cesarean delivery: a case report. J Reprod Med 2008; 53:809.
  22. Arad I, Linder N, Bercovici B. Vacuum extraction at cesarean section--neonatal outcome. J Perinat Med 1986; 14:137.
  23. Obican SG, Brunner M, Larsen JW. Barton's forceps: An effective aid in cesarean deliveries. Contemporary OBGYN 2011. http://www.modernmedicine.com/modernmedicine/Modern+Medicine+Now/Bartons-forceps-An-effective-aid-in-cesarean-deliv/ArticleStandard/Article/detail/738940 (Accessed on September 21, 2011).