title: Hysterotomy to effect vaginal delivery with mentum anterior head entrapment.
abstract: BACKGROUND
  Entrapment of the aftercoming head after mentum anterior rotation is a life-threatening complication of vaginal breech delivery. Few options exist when rotation and flexion from this position cannot be performed successfully either transabdominally or with vaginal maneuvers.
  
  
  METHODS
  A term primigravida presented with a singleton breech in advanced labor. The fetal torso and arms delivered vaginally, but the aftercoming head became extended and was entrapped in a mentum anterior position. The fetal head could not be rotated and flexed, either vaginally or transabdominally with suprapubic pressure. Laparotomy and hysterotomy were performed, and vaginal delivery of a live fetus was accomplished after rotation and flexion of the fetal head through this incision.
  
  
  CONCLUSIONS
  Hysterotomy is a safe and effective maneuver for delivery of the entrapped fetal head with mentum anterior rotation after standard procedures have failed.
authors.affiliation: Department of Obstetrics and Gynecology, University of Vermont, Burlington, USA.
authors.forename: J K
authors.initials: JK
authors.lastname: Pollard
authors.forename: W L
authors.initials: WL
authors.lastname: Leaphart
authors.forename: T E
authors.initials: TE
authors.lastname: Braun
authors.forename: E L
authors.initials: EL
authors.lastname: Capeless
mesh_terms: D000293:Adolescent; D001946:Breech Presentation; D036861:Delivery, Obstetric / Q000379:methods*; D005260:Female; D006801:Humans; D007813:Laparotomy; D011247:Pregnancy; D014599:Uterus / Q000601:surgery*