Category: MANEUVERS

MAURICEAU-LEVRET

For delivering head at Breech Presentation

• Lift body vertically by the feet
• Introduce index finger in the mouth
• Let the body ride on your arm
  • On the abdomen
  • Legs hanging down on each side of the arm
• Flex the head with index finger in the mouth
• Apply traction with a forked finger grip posteriorly to the neck with the other hand.
• Apply fundal pressure by assistant

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INTERNAL VERSION AND EXTRACTION

For delivering breech and transverse presentations

• 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 by a combination of
  • Traction on the foot/feet
  • Upward pressure on caput with the other hand on mother’s abdomen
• Continue strong traction on foot/feet
• Combined with pumping movements
• Grasp the knee anteriorly with the other hand
• Extract lower part of the 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 movements
• Release the arms
• Deliver head by Mauriceau-Levret’s maneuver

ARM RELEASE

In Assisted Breech Delivery

• Release the posteriorly positioned arm first
• Use left hand when the back is turned to the (mother’s) right
  • And vice versa
• Place left thumb on the frontal aspect of the truncus
• Left index and middle fingers on the back
• Slide the hand inwards
• Along the truncus
• Until the thumb reaches the axilla
• With a sweeping movement across the head
• Bring the arm down with index and middle fingers
• Change hands
• Release the anteriorly positioned arm
  • Using the same technique

BURN-MARSHALL

• In Breech presentation
• Let the baby hang a short moment by the head
• To facilitate it’s descendens in the birth canal

LOEVSET

For delivering the shoulders

• Grasp lateral border of the scapula with four ulnar fingers of your hand
• Rotate truncus 180°
• Use right hand when the back is turned to the (mother’s) left
  • And vice versa
• The birth canal is shorter anteriorly
• Bringing the posterior shoulder anteriorly will deliver it