title: Comparison of neonatal and maternal outcomes associated with head-pushing and head-pulling methods for impacted fetal head extraction during cesarean delivery.
abstract: 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).
  
  
  CONCLUSIONS
  Owing to a lower rate of abnormal incision and postpartum fever/infection with the pull method, this technique is preferable to the push method.
authors.affiliation: Department of Obstetrics and Gynecology, Taleghani Hospital, Women's Reproductive Health Research Center, Tabriz University of Medical Science, Tabriz, Iran.
authors.forename: Parvin
authors.initials: P
authors.lastname: Bastani
authors.forename: Shabnam
authors.initials: S
authors.lastname: Pourabolghasem
authors.forename: Shabnam
authors.initials: S
authors.lastname: Pourabolghase
authors.forename: Fatemeh
authors.initials: F
authors.lastname: Abbasalizadeh
authors.forename: Leila
authors.initials: L
authors.lastname: Motvalli
mesh_terms: D000328:Adult; D002585:Cesarean Section / Q000379:methods*; D004420:Dystocia; D005260:Female; D005334:Fever / Q000453:epidemiology / Q000209:etiology; D006257:Head; D006801:Humans; D007231:Infant, Newborn; D007746:Labor Presentation; D007748:Labor Stage, Second; D007744:Obstetric Labor Complications; D049590:Postpartum Period; D011247:Pregnancy; D011256:Pregnancy Outcome; D011645:Puerperal Infection / Q000453:epidemiology; D055815:Young Adult