Disengagement of the Deeply Engaged Fetal Head during Cesarean Section- Conventional Method versus Reverse Breech Extraction- Review of Literature

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.