Zavanelli's Maneuver
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Zavanelli's Maneuver
The Zavanelli maneuver is an obstetric maneuver that involves pushing back the delivered fetal head into the birth canal in anticipation of performing a cesarean section in cases of shoulder dystocia. The Zavanelli maneuver is performed only after other maneuvers have failed, as it is associated with high risk to both the mother and the fetus. A review published in 1985 found that 84 of 92 cases of Zavanelli maneuver were successful in replacing the head of the fetus back into the uterus. Risks of the maneuver to the mother include soft tissue damage and puerperal sepsis. The Zavanelli maneuver is not performed very often in the United States. It is named after William Angelo "Bill" Zavanelli (born October 10, 1926), who performed the procedure on January 18, 1978 as a clinical instructor in obstetrics and gynecology at the University of California, San Francisco. See also * McRoberts maneuver * Wood's screw maneuver * Shoulder dystocia Shoulder dystocia occurs after vagi ...
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Obstetrics
Obstetrics is the field of study concentrated on pregnancy, childbirth and the postpartum period. As a medical specialty, obstetrics is combined with gynecology under the discipline known as obstetrics and gynecology (OB/GYN), which is a surgical field. Main areas Prenatal care Prenatal care is important in screening for various complications of pregnancy. This includes routine office visits with physical exams and routine lab tests along with telehealth care for women with low-risk pregnancies: Image:Ultrasound_image_of_a_fetus.jpg, 3D ultrasound of fetus (about 14 weeks gestational age) Image:Sucking his thumb and waving.jpg, Fetus at 17 weeks Image:3dultrasound 20 weeks.jpg, Fetus at 20 weeks First trimester Routine tests in the first trimester of pregnancy generally include: * Complete blood count * Blood type ** Rh-negative antenatal patients should receive RhoGAM at 28 weeks to prevent Rh disease. * Indirect Coombs test (AGT) to assess risk of hem ...
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Fetus
A fetus or foetus (; : fetuses, foetuses, rarely feti or foeti) is the unborn offspring of a viviparous animal that develops from an embryo. Following the embryonic development, embryonic stage, the fetal stage of development takes place. Prenatal development is a continuum, with no clear defining feature distinguishing an embryo from a fetus. However, in general a fetus is characterized by the presence of all the major body organs, though they will not yet be fully developed and functional, and some may not yet be situated in their final Anatomy, anatomical location. In human prenatal development, fetal development begins from the ninth week after Human fertilization, fertilization (which is the eleventh week of Gestational age (obstetrics), gestational age) and continues until the childbirth, birth of a newborn. Etymology The word ''wikt:fetus#English, fetus'' (plural ''wikt:fetuses#English, fetuses'' or rarely, the solecism ''wikt:feti#English, feti''''Oxford English Dict ...
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Cesarean Section
Caesarean section, also known as C-section, cesarean, or caesarean delivery, is the surgical procedure by which one or more babies are delivered through an incision in the mother's abdomen. It is often performed because vaginal delivery would put the mother or child at risk (of paralysis or even death). Reasons for the operation include, but are not limited to, obstructed labor, twin pregnancy, high blood pressure in the mother, breech birth, shoulder presentation, and problems with the placenta or umbilical cord. A caesarean delivery may be performed based upon the shape of the mother's pelvis or history of a previous C-section. A trial of vaginal birth after C-section may be possible. The World Health Organization recommends that caesarean section be performed only when medically necessary. A C-section typically takes 45 minutes to an hour. It may be done with a spinal block, where the woman is awake, or under general anesthesia. A urinary catheter is used to drain the ...
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Shoulder Dystocia
Shoulder dystocia occurs after vaginal delivery of the head, when the baby's anterior shoulder is obstructed by the mother's pubic bone. It is typically diagnosed when the baby's shoulders fail to deliver despite gentle downward traction on the baby's head, requiring the need of special techniques to safely deliver the baby. Retraction of the baby's head back into the vagina, known as "turtle sign" is suggestive of shoulder dystocia. It is a type of obstructed labour. Although most instances of shoulder dystocia are relieved without complications to the baby, the most common complications may include brachial plexus injury, or clavicle fracture. Complications for the mother may include increased risk of vaginal or perineal tears, postpartum bleeding, or uterine rupture. Risk factors include gestational diabetes, previous history of the condition, operative vaginal delivery, obesity in the mother, an overly large baby, and epidural anesthesia. Shoulder dystocia is an obste ...
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Puerperal Sepsis
Postpartum infections, also known as childbed fever and puerperal fever, are any bacterial infections of the female reproductive tract following childbirth or miscarriage. Signs and symptoms usually include a fever greater than , chills, lower abdominal pain, and possibly odorous vaginal discharge. It usually occurs after the first 24 hours and within the first ten days following delivery. The most common infection is that of the uterus and surrounding tissues known as puerperal sepsis, postpartum metritis, or postpartum endometritis. Risk factors include caesarean section (C-section), the presence of certain bacteria such as group B streptococcus in the vagina, premature rupture of membranes, multiple vaginal exams, manual removal of the placenta, and prolonged labour among others. Most infections involve a number of types of bacteria. Diagnosis is rarely helped by culturing of the vagina or blood. In those who do not improve, medical imaging may be required. Other causes of ...
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Obstetrics And Gynecology
Obstetrics and gynaecology (also spelled as obstetrics and gynecology; abbreviated as Obst and Gynae, O&G, OB-GYN and OB/GYN) is the medical specialty that encompasses the two subspecialties of obstetrics (covering pregnancy, childbirth, and the postpartum period) and gynaecology (covering the health of the female reproductive system – vagina, uterus, ovaries, and Breast, breasts). The specialization is an important part of care for women's health. Postgraduate training programs for both fields are usually combined, preparing the practising obstetrician-gynecologist to be adept both at the care of female reproductive organs' health and at the management of pregnancy, although many doctors go on to develop subspecialty interests in one field or the other. Scope United States According to the American Board of Obstetrics and Gynecology (ABOG), which is responsible for issuing OB-GYN certifications in the United States, the first step to OB-GYN certification is completing medi ...
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University Of California, San Francisco
The University of California, San Francisco (UCSF) is a Public university, public Land-grant university, land-grant research university in San Francisco, California, United States. It is part of the University of California system and is dedicated entirely to health science and life science. It conducts research and teaching in Medicine, medical and biology, biological sciences. UCSF was founded as Toland Medical College in 1864. In 1873, it became affiliated with the University of California as its Medical Department. In the same year, it incorporated the California College of Pharmacy and in 1881 it established a dentistry school. Its facilities were located in both Berkeley, California, Berkeley and San Francisco. In 1964, the school gained full administrative independence as a campus of the UC system, headed by its own chancellor, and in 1970 it gained its current name. Historically based at List of neighborhoods in San Francisco#Parnassus, Parnassus Heights with satellite ...
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McRoberts Maneuver
The McRoberts maneuver is an obstetrical maneuver used to assist in childbirth. It is named after William A. McRoberts, Jr. It is employed in case of shoulder dystocia during childbirth and involves hyperflexing the mother's legs tightly to her abdomen. It is effective due to the increased mobility at the sacroiliac joint during pregnancy, allowing rotation of the pelvis and facilitating the release of the fetal shoulder. If this maneuver does not succeed, an assistant applies pressure on the lower abdomen (suprapubic pressure). Current guidelines strongly recommend against pulling on the infants head, as this could lead to brachial plexus injury. Instead, support while keeping the neck straight is indicated. The technique is effective in about 42% of cases. Note that suprapubic pressure and McRobert's maneuver together will resolve 90% of cases. See also * Wood's screw maneuver * Zavanelli maneuver * Shoulder dystocia * Shoulder dystocia#Treatment, Treatment of shoulder dy ...
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Wood's Screw Maneuver
Wood's screw maneuver is practiced in obstetrics when dealing with shoulder dystocia – a condition in which the fetal shoulders cannot easily pass through the vagina. In this maneuver the anterior shoulder is pushed towards the baby's chest, and the posterior shoulder is pushed towards the baby's back, making the baby's head somewhat face the mother's rectum. This maneuver is tried only after the McRoberts maneuver, and application of suprapubic (lower abdomen) pressure have been tried. It is named after Wood, who was the first to examine this maneuver in detail. See also * McRoberts maneuver * Zavanelli maneuver * Shoulder dystocia Shoulder dystocia occurs after vaginal delivery of the head, when the baby's anterior shoulder is obstructed by the mother's pubic bone. It is typically diagnosed when the baby's shoulders fail to deliver despite gentle downward traction on the b ... * The mechanics of birth References {{Obstetrical procedures Obstetrical procedures< ...
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Shoulder Dystocia
Shoulder dystocia occurs after vaginal delivery of the head, when the baby's anterior shoulder is obstructed by the mother's pubic bone. It is typically diagnosed when the baby's shoulders fail to deliver despite gentle downward traction on the baby's head, requiring the need of special techniques to safely deliver the baby. Retraction of the baby's head back into the vagina, known as "turtle sign" is suggestive of shoulder dystocia. It is a type of obstructed labour. Although most instances of shoulder dystocia are relieved without complications to the baby, the most common complications may include brachial plexus injury, or clavicle fracture. Complications for the mother may include increased risk of vaginal or perineal tears, postpartum bleeding, or uterine rupture. Risk factors include gestational diabetes, previous history of the condition, operative vaginal delivery, obesity in the mother, an overly large baby, and epidural anesthesia. Shoulder dystocia is an obste ...
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Childbirth
Childbirth, also known as labour, parturition and delivery, is the completion of pregnancy, where one or more Fetus, fetuses exits the Womb, internal environment of the mother via vaginal delivery or caesarean section and becomes a newborn to the world. In 2019, there were about 140.11 million human births globally. In Developed country, developed countries, most deliveries occur in hospitals, while in Developing country, developing countries most are home births. The most common childbirth method worldwide is vaginal delivery. It involves four stages of labour: the cervical effacement, shortening and Cervical dilation, opening of the cervix during the first stage, descent and birth of the baby during the second, the delivery of the placenta during the third, and the recovery of the mother and infant during the fourth stage, which is referred to as the Postpartum period, postpartum. The first stage is characterised by abdominal cramping or also back pain in the case of B ...
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