Category: TRANSVERSE PRESENTATION

Transverse presentation is often accompanied by arm prolapse (compound transverse presentation).

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GESTATIONAL AGE < 32 WEEKS / WEIGHT < 1500 GRAM

• Vaginal delivery

GESTATIONAL AGE > 32 WEEKS / WEIGHT > 1500 GRAM

ALIVE FETUS

• Cervix closed:
  • Cesarean Sectio

• Cervix closed and membranes intact:
  • External Version

• Cervix fully dilated / Membranes ruptured recently / Contractions not very strong:
  • Internal version and extraction using one or both feet
    • 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 with a combination of
      • Traction on foot/feet
      • Upward pressure on caput with other hand on mother’s abdomen
    • Continue strong traction on foot/feet
    • Combined with pumping movements
    • Grasp front of knee with the other hand
    • Extract the upper part of 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 movementsRelease arms
    • Deliver head by Mauriceau-Levret’s maneuver

DEAD FETUS

• Destructive delivery
  • Decapitation
  • Exvisceration

BETWEEN 32 – 34 WEEKS / 1500 – 2500 gram

Relay on your own judgement