Procedure to be performed in case of arrest of after coming head due to contracted pelvis in breech:
**Core Concept**
In cases of obstructed labor due to a contracted pelvis, the fetal head may become arrested, leading to a life-threatening situation for both the mother and the fetus. The Zavanelli maneuver is a procedure used to manage this emergency situation.
**Why the Correct Answer is Right**
The Zavanelli maneuver involves pushing the fetus back up into the uterus and delivering it vaginally. This procedure is typically performed when a fetal head is stuck in the pelvis and a cesarean section is not immediately feasible. The maneuver requires great care and precision to avoid causing further injury to the fetus or the mother. By pushing the fetus back into the uterus, the Zavanelli maneuver allows for a controlled delivery, minimizing the risk of complications.
**Why Each Wrong Option is Incorrect**
**Option A:** Craniotomy is a procedure that involves removing a portion of the fetal skull to facilitate delivery. However, this is not a suitable option in cases of arrested head due to a contracted pelvis, as it would not address the underlying issue and may cause further harm to the fetus.
**Option B:** Decapitation is a procedure that involves separating the fetus's head from its body to facilitate delivery. This is an extremely rare and last-resort option, and it is not applicable in cases of arrested head due to a contracted pelvis.
**Option D:** Cleidotomy is a procedure that involves removing a portion of the fetal clavicle to facilitate delivery. However, this is not a suitable option in cases of arrested head due to a contracted pelvis, as it would not address the underlying issue and may cause further harm to the fetus.
**Clinical Pearl / High-Yield Fact**
The Zavanelli maneuver should only be performed in emergency situations where a cesarean section is not immediately feasible, and the fetal head is at risk of further injury. It requires great care and precision to avoid causing complications.
**✓ Correct Answer: C. Zavanelli maneuver**