During LTCS, the fetal head traditionally is delivered by one-hand manual extraction (a surgeon inserts one hand into the uterus via the hysterotomy and lifts the fetal head out of maternal pelvis, subsequently significant abdominal pressure is required to squeeze the fetal head out of hysterotomy) along with application of significant abdominal/fundal pressure.

An innovative approach to manual head extraction, with surgeon's both hands formed as a pair of forceps, has been used by the PI of this study for years during the LTCS for head extraction in the difficult situations described above without complication, often time it was used after one hand approach failed to deliver the infant, vacuum/forceps and abdominal pressure usually was not needed in these cases.

Pregnancy Related

Delivery Complication

Cesarean Delivery Affecting Fetus

see above for the description about one-hand and two-hand fetal head extraction technique

Fetal head extraction technique during the cesarean section

Reading Hospital Labor & Delivery

Hand Forceps vs. Conventional One-hand Technique for Fetal Head Extraction During Cesarean Section

Efficacy and Safety Comparison of an Innovative Two-hand vs. Conventional One-hand Technique for Fetal Head Manual Extraction During a Low Transverse Cesarean Section: A Randomized Controlled Study

Time from entry of uterus to delivery of fetal head (U-D interval)

incidence of extension of uterine incision as well as other adverse events

Xuezhi (Daniel) Jiang, MD

Research and Clerkship Director of OBGYN

The Reading Hospital and Medical Center

Arm 1: Fetal head is extracted by conventional one-hand (in hysterotomy) technique during the C-section Arm 2: Fetal head is extracted by an innovative two-hand (in hysterotomy) technique during the C-section

Women at term in second or third phase of labor who are indicated to have an IUPC during active labor

Uterine Pressure Measurement

The EHG uses a Graphium electrode patch that is applied to the abdomen and records electrical activity non-invasively

Electrohysterography

article describing the benefit of the electrohysterography

uterine rupture/köklük

Hand Forceps vs. Conventional One-hand Technique for Fetal Head Extraction During Cesarean Section

Accuracy of Electrohysterography in Assessing Intrauterine Pressure

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