Abdominal rescue using the vacuum extractor after entrapment of the aftercoming head

Helain J. Landy, Luis Zarate, Mary J. O’Sullivan

Research output: Contribution to journalArticlepeer-review

14 Scopus citations


Background: Fetal replacement into the uterus for cesarean delivery after failed vaginal delivery has been reported for both vertex and breech presentations. Although an option, this mode of delivery frequently is the last maneuver to deliver a viable infant after other methods to allow vaginal delivery have failed. We report the adjunctive use of a vacuum extractor to facilitate abdominal rescue after entrapment of the aftercoming head during an attempted vaginal breech delivery. Case: A multiparous woman presented at term with two fetal feet bulging through the membranes at the introitus. During vaginal breech delivery, the aftercoming head became entrapped. Unsuccessful maneuvers to facilitate descent included Duhrssen incisions, the Mauriceau maneuver, placement of Piper forceps, and halothane administration. At emergency cesarean delivery, the infant was pushed upward from below, and rapid, successful delivery of a 2530-g neonate was accomplished with assistance by a vacuum extractor. Apgar scores were 3, 6, and 7 at 1, 5, and 10 minutes, respectively. Umbilical artery blood gas revealed a pH of 7.18 and base excess of -6. A head sonogram and electroencephalogram were normal. Both mother and infant were discharged without complications. Conclusion: After entrapment of the aftercoming head during attempted vaginal breech delivery, use of the vacuum extractor may expedite the abdominal rescue and cesarean.

Original languageEnglish (US)
Pages (from-to)644-646
Number of pages3
JournalObstetrics and gynecology
Issue number4
StatePublished - Oct 1994

ASJC Scopus subject areas

  • Obstetrics and Gynecology


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