Comparison of Maternal Infectious Morbidity of Two Methods of Fetal Delivery During Cesarean Section at Full Cervical Dilatation

Abstract

Background: Caesarean section at full cervical dilatation is accompanied by higher risks of complications including the difficulties in delivering babies with deeply impacted heads. Different techniques are used to deal with this challenge. The two commonly used methods are push method and pull method. Objectives: To compare maternal infectious morbidity between reverse breech extraction and vaginal head push technique, for delivering baby, during second stage cesarean section. Materials and Methods: A total of 170 women with caesarean section at full cervical dilatation due to failure to progress, singleton alive fetus, cephalic presentation took part in this observational study conducted, from 1st February 2019 to 31st January 2022 at OBGYN Department LRH, MTI Peshawar. Women with multiple pregnancies, fetal distress, fetal anomalies, previous uterine scar, chorioamniotis, fever were excluded. In Group I women, head push technique and, in group II women, pull method was performed. All women were followed till first week of birth for pyrexia, wound infections and blood transfusion.Results: Maternal pyrexia developed in 13 (15.29%) patients in the pull method/Group II women, and 25 (29.41%) in the push approach group (p = 0.047). Infection of caesarean wound occurred in 04 (4.71%) in Group II, and 12 (14.12%) of Group I women (p = 0.065). Blood transfusion was needed in 25(29.41%) of Group II and, in 19(22.35%) cases of Group I (p=0.381).Conclusion: This study concluded that maternal outcome in terms of infectious morbidity is better after breech extraction in caesarean section during second stage of labour.Keywords: Head push, pyrexia, Reverse breech extraction, Wound infection.