Related Experiment Video
Updated: May 23, 2026
External Cephalic Version: Is it an Effective and Safe Procedure?
Published on: June 6, 2020
Comparison of neonatal and maternal outcomes associated with head-pushing and head-pulling methods for impacted fetal
Parvin Bastani1, Shabnam Pourabolghasem, Shabnam Pourabolghase
1Department of Obstetrics and Gynecology, Taleghani Hospital, Women's Reproductive Health Research Center, Tabriz University of Medical Science, Tabriz, Iran.
Objective:
To compare the morbidity and mortality of 2 current techniques during cesarean delivery of an impacted fetal head.
Methods:
In a comparative setting, 59 pregnant women with obstructed labor due to impacted fetal head were recruited. The patients were categorized into 2 groups according to method of extraction: the "push" group (n=30) and the "pull" group (n=29). Uterus relaxants were used before cesarean in all cases and the incision was higher and wider than routine. Maternal and neonatal morbidities were compared between the groups.
Results:
Maternal complications in the push and pull groups were extension of the uterine incision (15 [50.0%] vs 5 [17.2%]); T or J incision (3 [10.0%] vs 4 [13.8%]); blood transfusion (3 [10.0%] vs 1 [3.4%]); wound infection (4 [13.3%] vs 1 [3.4%]); fever (16 [53.3%] vs 3 [10.3%]); and urinary tract infection (10 [33.3%] vs 0 [0.0%]). Incidences of extension of the uterine incision, fever, and urinary tract infection were significantly higher in the push group (P=0.008).
Conclusion:
Owing to a lower rate of abnormal incision and postpartum fever/infection with the pull method, this technique is preferable to the push method.