title: Reverse breech extraction versus head pushing in cesarean section for obstructed labor. A comparative study in Yemen.
abstract: OBJECTIVE
  To compare the maternal and fetal outcome of 2 different methods of delivering the baby during cesarian section when the fetal head is deeply engaged.
  
  
  METHODS
  A prospective case control study was carried out in the Obstetrics and Gynecology Department, Al-Thawra General Hospital, Sana'a, Yemen from January to December 2010. A total of 118 women who met our criteria were included in the study. They were divided randomly into 2 groups. A study group (n=59) was assigned to deliver the baby by reverse breech extraction, and control group (n=59) was assigned to deliver by the conventional method. The maternal and neonatal outcomes between the 2 groups were compared.
  
  
  RESULTS
  Extension of the uterine incision occurred in significantly less women using reverse breech extraction compared to cephalic delivery (5% versus 40.6%; p=0.0001). It was observed that the mean operation time and blood loss in the study group were lower than that in the control group (52.9 +/- 5.1, 787 +/- 519 versus 67.2 +/- 4.7, 1231 +/- 471; p<0.0001). No significant difference between groups was noted in the maternal and neonatal outcomes.
  
  
  CONCLUSIONS
  Reverse breech extractions is an attractive and safe alternative to the standard method for intraoperative disengagement of a deeply impacted fetal head in order to reduce maternal and fetal morbidly.
authors.affiliation: Department of the Obstetrics and Gynecology, Al-Thawra General Hospital, Thamar University, Sana'a, Yemen.
authors.forename: Kaima A
authors.initials: KA
authors.lastname: Frass
authors.forename: Abdulhakim
authors.initials: A
authors.lastname: Al Eryani
authors.forename: Abdelrahman H
authors.initials: AH
authors.lastname: Al-Harazi
mesh_terms: D000328:Adult; D001946:Breech Presentation; D016022:Case-Control Studies; D002585:Cesarean Section; D005260:Female; D006801:Humans; D011247:Pregnancy; D011446:Prospective Studies; D015006:Yemen