Document Detail

Abdominal rescue after failed cephalic replacement.
MedLine Citation:
PMID:  1495726     Owner:  NLM     Status:  MEDLINE    
BACKGROUND: Since the introduction of cephalic replacement for shoulder dystocia, the management of failures has not been addressed. The purpose of this report is to describe abdominal hysterotomy as an alternative approach to the resolution of shoulder dystocia. CASE: A 21-year-old woman, gravida 1, experienced severe shoulder dystocia following partial delivery of a 4320-g infant. Classical maneuvers as well as cephalic replacement were unsuccessful before and after general anesthesia. A low transverse hysterotomy permitted manual rotation of the anterior shoulder to the oblique diameter and further descent of the posterior shoulder. Delivery of the posterior arm was then completed without difficulty. CONCLUSION: Persistent failed cephalic replacement, especially after general anesthesia, can be successfully resolved with a hysterotomy using a low transverse uterine incision.
J A O'Leary; A Cuva
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Publication Detail:
Type:  Case Reports; Journal Article    
Journal Detail:
Title:  Obstetrics and gynecology     Volume:  80     ISSN:  0029-7844     ISO Abbreviation:  Obstet Gynecol     Publication Date:  1992 Sep 
Date Detail:
Created Date:  1992-09-10     Completed Date:  1992-09-10     Revised Date:  2009-10-26    
Medline Journal Info:
Nlm Unique ID:  0401101     Medline TA:  Obstet Gynecol     Country:  UNITED STATES    
Other Details:
Languages:  eng     Pagination:  514-6     Citation Subset:  AIM; IM    
Department of Obstetrics and Gynecology, St. Luke's Hospital, Bethlehem, Pennsylvania.
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MeSH Terms
Cesarean Section*
Dystocia / etiology,  surgery*
Fetal Macrosomia / complications*
Labor Presentation*

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