Internal podalic version for delivery of high floating head during cesarean section and neonatal outcome.

Abstract

To evaluate the technique of internal podalic version for delivery of high floating head during cesarean section as an alternative for other methods for its delivery and its effects on neonatal outcome. This study used clinical randomized controlled study design. Three groups of patients each group has 50 patients who attended for elective cesarean section and found to have high floating head during operation, Group I: the babies were delivered by internal podalic version. Group II: the babies were delivered by short curved forceps. Group III: the babies were delivered by vacuum. All groups were compared in regard to time required for delivery of baby, fetal condition, maternal complications, fetal complications and postoperative complications. Hundred-and-fifty patients were selected in the course of preparation of elective cesarean section, all had high floating fetal head, and they were randomly distributed into three groups, each group had 50 patients. There was significant relationship for the favor of Group 1 (study group) as regard the time required for the maneuver as calculated from the end of uterine incision till delivery of whole baby, (24.86, 59.48,54.52 s for Group I, Group II, Group III, respectively) with P-value <0.00001*. Also there was significant relationship as regard the intraoperative maternal complications for the favor of Group I with P-value =0.004. While there was an insignificant relationship between the three groups as regard preoperative data, APGAR score, fetal birth weight, postoperative pain and postoperative maternal data. Despite that there was a significant difference as regard the postoperative neonatal complications, with P-value =0.002*, all these complications were minor and did not need long-term treatment. Use of internal podalic version for delivery of high floating head during cesarean section is a safe and rapid technique, with less maternal and neonatal complications.