The Experts below are selected from a list of 168 Experts worldwide ranked by ideXlab platform
Vanita Suri - One of the best experts on this subject based on the ideXlab platform.
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disengagement of the deeply engaged fetal head during cesarean section in advanced labor conventional method versus reverse Breech Extraction
Acta Obstetricia et Gynecologica Scandinavica, 2009Co-Authors: Seema Chopra, Rashmi Bagga, Anish Keepanasseril, Vanita Jain, Jasvinder Kalra, Vanita SuriAbstract:Maternal and fetal morbidity of two different methods of delivering the baby during cesarean section performed in advanced labor when the fetal head is deeply engaged was assessed retrospectively, i.e. delivering as ‘cephalic’ with or without assistance to push up the fetal head from the vagina (head first or push method) and ‘reverse Breech Extraction’ (feet first or pull method). Records of 182 women with a single fetus in cephalic presentation, who had undergone cesarean section at cervical dilatation at ≥7 cm, with the vertex at or below zero station, were reviewed. Extension of the uterine incision occurred in significantly more women during ‘cephalic’ delivery as compared to ‘reverse Breech Extraction’ (22.8% versus 2.2%; p=0.001). Use of ‘reverse Breech Extraction’ is an attractive and safe alternative to the standard methods for intra-operative disengagement of a deeply impacted fetal head in order to reduce maternal and fetal morbidity.
Seema Chopra - One of the best experts on this subject based on the ideXlab platform.
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disengagement of the deeply engaged fetal head during cesarean section conventional method versus reverse Breech Extraction review of literature
clinics in Mother and Child Health, 2016Co-Authors: Seema ChopraAbstract:Obstructed labor with the fetal head impacted in pelvis is an obstetric complication that requires cesarean delivery with skilful handling. Extraction and delivery of the fetal head in this situation can be achieved utilizing either an ‘abdomino-vaginal’ approach or ‘reverse Breech Extraction’. Other techniques include use of a ‘Dis impaction system’ or ‘Patwardhan technique’. However, caesarean delivery cannot provide assurance against maternal and neonatal morbidity. Evidence is needed to guide clinicians as to which technique; reverse Breech Extraction or push method best facilitates delivery with the least complications for mother and baby. The superiority of one technique over another is yet to be proven. The present review indicates that the pull technique has relative advantages over the push method in cases of impacted fetal head at cesarean delivery with regard to fetal and maternal complications.
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disengagement of the deeply engaged fetal head during cesarean section in advanced labor conventional method versus reverse Breech Extraction
Acta Obstetricia et Gynecologica Scandinavica, 2009Co-Authors: Seema Chopra, Rashmi Bagga, Anish Keepanasseril, Vanita Jain, Jasvinder Kalra, Vanita SuriAbstract:Maternal and fetal morbidity of two different methods of delivering the baby during cesarean section performed in advanced labor when the fetal head is deeply engaged was assessed retrospectively, i.e. delivering as ‘cephalic’ with or without assistance to push up the fetal head from the vagina (head first or push method) and ‘reverse Breech Extraction’ (feet first or pull method). Records of 182 women with a single fetus in cephalic presentation, who had undergone cesarean section at cervical dilatation at ≥7 cm, with the vertex at or below zero station, were reviewed. Extension of the uterine incision occurred in significantly more women during ‘cephalic’ delivery as compared to ‘reverse Breech Extraction’ (22.8% versus 2.2%; p=0.001). Use of ‘reverse Breech Extraction’ is an attractive and safe alternative to the standard methods for intra-operative disengagement of a deeply impacted fetal head in order to reduce maternal and fetal morbidity.
Martina Kreft - One of the best experts on this subject based on the ideXlab platform.
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maternal and neonatal outcome of reverse Breech Extraction of an impacted fetal head during caesarean section in advanced stage of labour a retrospective cohort study
BMC Pregnancy and Childbirth, 2019Co-Authors: Franziska Lenz, Nina Kimmich, Roland Zimmermann, Martina KreftAbstract:Caesarean section with Extraction of a deeply impacted fetal head is technically challenging and is associated with serious maternal and neonatal complications. The purpose of the study was to identify risks and evaluate selected outcome parameters associated with difficult fetal head Extraction during caesarean section in advanced labour comparing two different Extraction techniques (head pushing vs. reverse Breech). This retrospective cohort study was conducted at the Division of Obstetrics in a tertiary care hospital in Zurich, Switzerland. 629 women at term with a singleton pregnancy in cephalic presentation during advanced intrapartum caesarean section from December 2012 until December 2016 were evaluated. Primary outcome was the incidence of uterine incision extensions. Secondary outcomes were other selected maternal and neonatal outcome parameters. Data analysis was performed using SPSS with Mann-Whitney U independent sampling test and two-tailed Fisher’s exact test (p < 0.01). Difficult fetal head Extractions are associated with significantly elevated maternal and neonatal risks. When performed by reverse Breech technique, significant lower rates of extensions of the uterine incision, shorter operation times and less operative blood loss were identified compared to the head pushing method. No statistically significant differences for the neonatal outcomes were described so far. However, among the group of difficult fetal delivery with the head pushing method two neonates had perinatal skull fractures, with one of those resulting in neonatal death. The head pushing method is associated with higher maternal morbidity than the reverse Breech method for Extraction of a deeply engaged fetus during intrapartum caesarean section in advanced stage of labour.
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Maternal and neonatal outcome of reverse Breech Extraction of an impacted fetal head during caesarean section in advanced stage of labour: a retrospective cohort study
BMC, 2019Co-Authors: Franziska Lenz, Nina Kimmich, Roland Zimmermann, Martina KreftAbstract:Abstract Background Caesarean section with Extraction of a deeply impacted fetal head is technically challenging and is associated with serious maternal and neonatal complications. The purpose of the study was to identify risks and evaluate selected outcome parameters associated with difficult fetal head Extraction during caesarean section in advanced labour comparing two different Extraction techniques (head pushing vs. reverse Breech). Methods This retrospective cohort study was conducted at the Division of Obstetrics in a tertiary care hospital in Zurich, Switzerland. 629 women at term with a singleton pregnancy in cephalic presentation during advanced intrapartum caesarean section from December 2012 until December 2016 were evaluated. Primary outcome was the incidence of uterine incision extensions. Secondary outcomes were other selected maternal and neonatal outcome parameters. Data analysis was performed using SPSS with Mann-Whitney U independent sampling test and two-tailed Fisher’s exact test (p
Marie Victoire Sénat - One of the best experts on this subject based on the ideXlab platform.
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Internal Version Compared With Pushing for Delivery of Cephalic Second Twins
Obstetrics and Gynecology, 2020Co-Authors: Victoire Pauphilet, Elie Azria, Françcois O. Goffinet, Aurélien Seco, Anne Gaël Cordier, Philippe Deruelle, Gilles Kayem, Patrick Rozenberg, Nicolas Sananès, Marie Victoire SénatAbstract:OBJECTIVE: To assess neonatal morbidity and mortality according to whether cephalic second twins were born after internal version followed by total Breech Extraction or after instructions to push. We hypothesized that interval version would result in shorter intertwin delivery intervals and lower cesarean delivery rates for the second twin and therefore better neonatal outcomes. METHODS: These planned analyses of the JUMODA (JUmeaux MODe d'Accouchement) cohort, a national prospective population-based study of twin deliveries, examined births of cephalic second twins after vaginal birth of the first twin at or after 32 weeks of gestation. The internal version group of second twins born in Breech presentation after obstetric maneuvers was compared with the pushing group, comprising those born in cephalic presentation. The primary outcome was a composite of neonatal morbidity and mortality. Multivariate modified Poisson regression models were used to control for potential confounders. RESULTS: Of 2,256 cephalic second twins, 487 (21.6%) were born in Breech presentation after internal version and total Breech Extraction and 1,769 (78.4%) in cephalic presentation after pushing. Composite neonatal morbidity and mortality was not lower in the internal version (17/487 [3.5%]) compared with the pushing group (38/1,769 [2.1%]; adjusted relative risk [aRR] 1.73 [95% CI 0.98-3.05]), although median [quartile 1-quartile 3] intertwin delivery intervals were shorter (5 [4-8] vs 8 [5-12] minutes, P
James N Martin - One of the best experts on this subject based on the ideXlab platform.
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delivery of the nonvortex second twin Breech Extraction versus external cephalic version
American Journal of Obstetrics and Gynecology, 1995Co-Authors: Suneet P Chauhan, William E Roberts, Rodney A Mclaren, Holli Roach, John C Morrison, James N MartinAbstract:Abstract OBJECTIVE: Our purpose was to compare the maternal and perinatal outcomes of twin gestations in which the nonvortex second twin was delivered by total Breech Extraction versus those delivered by external cephalic version. STUDY DESIGN: The intrapartum courses of 284 consecutive twin gestations were analyzed retrospectively. Once those with actual birth weight RESULTS: The two groups were similar for mean (±SD) maternal age, gravidity, parity, gestational age at delivery, ultrasonographic estimate of birth weight for twin B, incidence of Breech or transverse presentation for the second fetus, and actual birth weight of the first or second newborn. Suspected fetal distress that led to cesarean delivery occurred significantly more often in parturients who underwent attempted external version ( 4 21 ) than total Breech Extraction ( 0 23 , p = 0.04 ). The incidence of eventual abdominal delivery was also significantly higher in patients who underwent attempted external cephalic version ( 10 21 ) rather than Breech Extraction ( 1 23 , p = 0.001 ). For twin B the occurrence of low Apgar scores at 1 minute was significantly higher for infants after attempted external version ( 7 21 ) rather than Breech Extraction ( 1 23 , p = 0.02 ), but the mean pH, number with Apgar scores CONCLUSION: On the basis of our experience, total Breech Extraction of the nonvertex second twin is preferable to external cephalic version because it appears to be associated with a significantly lower incidence of fetal distress and abdominal delivery with comparable neonatal outcome.