Abdominal rescue after incomplete delivery secondary to large fetal sacrococcygeal teratoma

Two cases are presented of incomplete vaginal delivery because of fetal sacrococcygeal teratomas. Prompt recognition and aggressive therapy resulted in favorable outcomes with minimal morbidity. The combined vaginal and abdominal manipulations involved repositioning the arms, shoulders, and vertex in the vagina, as the breech was extracted abdominally in a direction opposite to that ordinarily used. While this procedure seemed to work well, it is only applicable when the diagnosis of fetal tumor is made too late to prevent an obstructed delivery. Optimally, obstructed delivery is prevented by early ultrasonographic diagnosis and cesarean delivery before advanced labor.