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Published on: September 7, 2022
Internal podalic version for neglected shoulder presentation with fetal demise.
N N Mahajan1, N L Gaikwad, M V Solomon
1Department of Obstetrics and Gynaecology, Padhar Hospital, Padhar, Dist-Betul, Madhyapradesh, India. nirajdr@hotmail.com
Summary
Internal podalic version (IPV) can be effective for delivering a deceased fetus in singleton transverse lie pregnancies. This procedure offers a viable option when other methods are unsuitable.
Area of Science:
- Obstetrics and Gynecology
- Fetal Medicine
- Surgical Procedures
Background:
- Internal podalic version (IPV) is typically reserved for delivering the second twin.
- Its utility in singleton pregnancies, particularly with fetal demise, is less established.
- Neglected shoulder presentation poses significant delivery challenges.
Purpose of the Study:
- To evaluate the efficacy and safety of internal podalic version (IPV) for singleton pregnancies presenting with a transverse lie and fetal demise.
- To determine the feasibility of IPV in cases where vaginal delivery is complicated by fetal position and non-viability.
Main Methods:
- A retrospective study design was employed.
- The study included women with singleton pregnancies, transverse lie, and fetal demise, excluding those with live fetuses, prior Cesarean sections, or contracted pelves.
- The procedure involved manual repositioning of the prolapsed hand under anesthesia, followed by breech extraction.
Main Results:
- Twelve women underwent the procedure over a 19-month period.
- Internal podalic version (IPV) was successfully performed in all 12 cases.
- One patient experienced postpartum hemorrhage, indicating a manageable complication rate.
Conclusions:
- Internal podalic version (IPV) is an effective method for delivering non-viable fetuses in singleton pregnancies with a transverse lie.
- This technique provides a valuable alternative in specific obstetric scenarios, expanding the application of IPV beyond twin deliveries.
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