TRANSVERSE PRESENTATION

Transverse presentation is often accompanied by arm prolapse (compound transverse presentation).

GESTATIONAL AGE < 32 WEEKS / WEIGHT < 1500 GRAM

  • Vaginal delivery

GESTATIONAL AGE > 32 WEEKS / WEIGHT > 1500 GRAM

ALIVE FETUS

  • Cervix closed:
    • Cesarean Sectio

  • Cervix closed and membranes intact:
    • External Version

  • Cervix fully dilated / Membranes ruptured recently / Contractions not very strong:
    • Internal version and extraction using one or both feet
      • Introduce one hand in uterus
      • Search for small parts of the fetus
      • Identify one or both feet
        • Foot has a heal
        • Hand has a thumb
      • Grasp one or both feet with forked fingergrip from behind
      • Apply strong traction on the foot/feet
      • Rotate the fetus with a combination of
        • Traction on foot/feet
        • Upward pressure on caput with other hand on mother’s abdomen
      • Continue strong traction on foot/feet
      • Combined with pumping movements
      • Grasp front of knee with the other hand
      • Extract the upper part of body by a combination of
        • Strong traction
        • Pumping movements
      • Grasp pelvis with both hands
      • Extract upper part of body by a combination of
        • Strong traction
        • Pumping movementsRelease arms
      • Deliver head by Mauriceau-Levret’s maneuver

DEAD FETUS

  • Destructive delivery
    • Decapitation
    • Exvisceration

BETWEEN 32 – 34 WEEKS / 1500 – 2500 gram

Relay on your own judgement

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