Comparative study between pull (reverse breech technique) and push (conventional technique) during cesarean delivery in obstructed labor
Aims and Objectives: To compare the maternal and neonatal morbidities and to identify the etiology of obstructed labor and retrospective analyze the pull and push techniques for delivery of impacted head during cesarean section.
Method: This observational study was conducted in IPGME and R, SSKM medical college from April 2015 to Feb 2019. The study population included 74 women tackled with the pull method, while the control group comprised 74, age and parity matched who underwent the push method of head delivery.
Results: A review of 74 patients revealed the average age of the study population was 25.7±2 years. Patients with anemia (Hb≤8.5 to 10gm/dl) and abnormal BMI (>30and<24) were observed to suffer more from obstructed labor (p≤0.050). On the other hand, maternal height was not found to predict obstructed labor(p=0.5300). Patients with pull methods were noted to have less intra-operative fetal complication i.e. uterine artery injury (4 VS 19; P≤0.O5) transverse excision of the uterine incision (8vs 19; p≤0.05), vertical extension (1 vs 14; p ? 0.05)). Post-operative morbidity was also less, like fever( 01 vs31 ;p≤ 0.05), wound infection (2 vs 12; p≤ 0.05) and blood transfusion requirement (7 vs 16; p≤ 0.05), hospital stay more than seven days (4 vs 22; p≤ 0.05), There was no significant statistical difference between either group in terms of neonatal outcome.
Conclusion: Although the pull method may lead to some neonatal complications, it is associated with lower maternal morbidity than push method in impacted fetal head extraction during cesarean delivery. Thus, this method of head delivery may enable a better fetomaternal outcome in obstructed labor.
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