Safety of patwardhan technique in deeply engaged head

Bansiwal, Reeta; Anand, HP; Jindal, Meera

doi:10.18203/2320-1770.ijrcog20161325

Cited by 7 publications

(15 citation statements)

References 1 publication

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“…The Patwardhan manoeuvre is a modification of reverse breech extraction, where the arms are delivered first 40,61 . It is used more commonly in India, where the technique was first developed 61 .…”

Section: Techniques For Prevention and Managementmentioning

confidence: 99%

RETRACTED: Management of Impacted Fetal Head at Caesarean Birth

Cornthwaite¹,

Bahl²,

Winter³

et al. 2023

BJOG

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Plain language summaryOver one‐quarter of women in the UK have a caesarean birth (CB). More than one in 20 of these births occurs near the end of labour, when the cervix is fully dilated (second stage). In these circumstances, and when labour has been prolonged, the baby’s head can become lodged deep in the maternal pelvis making it challenging to deliver the baby. During the caesarean birth, difficulty in delivery of the baby’s head may result – this emergency is known as impacted fetal head (IFH). These are technically challenging births that pose significant risks to both the woman and baby. Complications for the woman include tears in the womb, serious bleeding and longer hospital stay. Babies are at increased risk of injury including damage to the head and face, lack of oxygen to the brain, nerve damage, and in rare cases, the baby may die from these complications.Maternity staff are increasingly encountering IFH at CB, and reports of associated injuries have risen dramatically in recent years. The latest UK studies suggest that IFH may complicate as many as one in 10 unplanned CBs (1.5% of all births) and that two in 100 babies affected by IFH die or are seriously injured. Moreover, there has been a sharp increase in reports of babies having brain injuries when their birth was complicated by IFH.When an IFH occurs, the maternity team can use different approaches to help deliver the baby’s head at CB. These include: an assistant (another obstetrician or midwife) pushing the head up from the vagina; delivering the baby feet first; using a specially designed inflatable balloon device to elevate the baby’s head and/or giving the mother a medicine to relax the womb. However, there is currently no consensus for how best to manage these births. This has resulted in a lack of confidence among maternity staff, variable practice and potentially avoidable harm in some circumstances.This paper reviews the current evidence regarding the prediction, prevention and management of IFH at CB, integrating findings from a systematic review commissioned from the National Guideline Alliance.

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Section: Techniques For Prevention and Managementmentioning

confidence: 99%

RETRACTED: Management of Impacted Fetal Head at Caesarean Birth

Cornthwaite¹,

Bahl²,

Winter³

et al. 2023

BJOG

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“…These findings were supported by Hol K et al, 7 Bansiwal et al 9 and Lal et al 12 in recent studies. 7,11,12 The mean duration of hospital stay was significantly less In women undergoing Patwardhan technique. This finding was statistically significant (p-value=0.027).…”

Section: Discussionmentioning

confidence: 96%

A comparative study between Patwardhan technique and push & pull method in women undergoing second stage of labor

Deshmukh¹,

Bandyopadhyay²,

kakade³

et al. 2022

IPCB

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Introduction: Obstructed labor with the fetal head impacted in the pelvis is an obstetric complication that requires caesarean delivery with skilful handling in an organized manner to avoid serious maternal and neonatal morbidity. The present study was undertaken to compare the Patwardhan technique with push and pull methods and also to evaluate the safety of Patwardhan technique. Material & methods: Study based on a total 90 pregnant women, of age 18 – 35 years with singleton pregnancy in second stage of labor with deeply impacted head, cases examined in labor room who gave consent and fulfilled inclusion criteria including inpatient admissions and referral randomly allocated in three groups 30 each.1. Patwardhan technique. 2. Push Technique 3. Pull technique. Results: Age, gestational age and duration of labor of the subjects in three were similar. There was significantly less incidence of uterine incision extension to either side, board ligament hematoma, intra-operative blood loss and traumatic Postpartum hemorrhage in subjects undergoing Patwardhan’s technique. With regards to neonatal outcome, wound infection, foetal injury and mean duration of hospital stay were significantly less in Patwardhan’s technique. Birth weight and APGAR scores were similar in all groups. Conclusion: There was less incidence of maternal and foetal morbidity in Patwardhan’s technique which makes it a preferred choice for management during second stage of labor

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“…Reeta Bansiwal et al 8 . study says that there was significant less uterine incision extension in Patwardhan group as compared to push and pull technique (1%,23.9%:p=0.01).…”

Section: Discussion:-mentioning

confidence: 99%

Comparison of Patwardhan and Push Method for Impacted Fetal Head Extraction During Caesarean Section.

Rakholia¹

2019

IJAR

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The incidence of second-stage Caesarean sections is greater in developing countries, where children are delivered to their homes by traditional birth attendants. The second stage cesarean represents a quarter of all primary cesarean sections 1 . Caesarean sections with complete cervical dilatation with impacted fetal heads are technically difficult because the inferior segment is thinned and edematous and therefore associated with an increased incidence of maternal and fetal morbidity 2 Delivery of the impacted fetal head in the second stage is technically difficult, and it is a main factor contributing to the associated increased complications 3 . The risks of postpartum maternal complications directly correlate with the duration of the second stage of labour and the mode of delivery 4 .The Patwardhan technique is a unique technique that was introduced by Dr. Patwardhan in 1957 to facilitate delivery of the head deeply affected in caesarean sections of the second stage and have fewer maternal and fetal pathologies. .Many women are referred from the periphery in advanced stages of obstructed labour to our hospital. Extraction and delivery of the fetal head in this situation can be achieved utilizing either abdomino-vaginal approach with head pushing up from the vagina 5 or Patwardhan technique, where the infant's shoulders are delivered first, then the trunk, breech, limbs and finally the head . So this study was undertaken to compare Patwardhan's technique with the push method and also to evaluate the safety of Patwardhan's technique. Material and Methods:-It is a prospective study including all caesarean sections done in second stage at Tertiary care centre, Haldwani. Patients were divided into two groups: group -1 where baby delivered by Patwardhan technique and group 2 where baby delivered by push technique. Both groups were compared in terms of maternal outcomes as uterine incision extensions, PPH, blood transfusions and neonatal outcomes in terms of their weight, APGAR and NICU stay. Inclusion criteria:Patient with single fetus at term in vertex presentation with full cervical dilatation with deeply impacted fetal head in maternal pelvis. Exclusion criteria:1. Multiple pregnancies 2. Previous caesarean section/myomectomy 3. Antepartum haemorrhage 4. Pregnancy less than 37 weeks

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Safety of patwardhan technique in deeply engaged head

Cited by 7 publications

References 1 publication

RETRACTED: Management of Impacted Fetal Head at Caesarean Birth

RETRACTED: Management of Impacted Fetal Head at Caesarean Birth

A comparative study between Patwardhan technique and push & pull method in women undergoing second stage of labor

Comparison of Patwardhan and Push Method for Impacted Fetal Head Extraction During Caesarean Section.

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