Reverse breech extraction in cases of second stage caesarean section.

Area of Science:

• Obstetrics and Gynecology
• Surgical Techniques
• Maternal-Fetal Medicine

Background:

• Cesarean section (CS) is a common surgical procedure.
• Second-stage CS presents unique challenges, particularly fetal head engagement in the pelvis.
• Alternative techniques are needed to improve outcomes in complex CS cases.

Purpose of the Study:

• To evaluate the feasibility of reverse breech extraction for fetal head disengagement during second-stage cesarean section (CS).
• To compare maternal and neonatal outcomes between reverse breech extraction and conventional methods in second-stage CS.

Main Methods:

• Retrospective evaluation of 50 women undergoing urgent second-stage CS.
• Comparison of 29 women delivered via reverse breech extraction (study group) with 21 women using the conventional approach (control group).
• Analysis of operative blood loss, hemoglobin drop, Apgar scores, cord pH, and newborn birth weights.

Main Results:

• Reverse breech extraction was successful in all 29 cases in the study group.
• No significant differences were observed in blood loss, hemoglobin drop, Apgar scores, cord pH, or newborn weights between the groups.
• Low rates of maternal and neonatal complications were noted, with no birth trauma or NICU admissions related to extraction.

Conclusions:

• Reverse breech extraction is a feasible and safe method for disengaging the fetal head during second-stage CS.
• The technique appears to be associated with low maternal and neonatal complication rates.
• Further research may support the adoption of this maneuver in specific clinical scenarios.