Management for breech with extended arm is done by-
Correct Answer: Lovsett's maneuver
Description: Ans. is 'c' i.e., Lovesett's maneuver Management of Breech with extended armso One or both the arms may be fully stretched along the side of the head or lie behind the neck (nuchal displacement)o The cause is usually due to faulty technique in delivery-using unnecessary traction, forgetting the principle of 'never pull but push from above'. Arrest occurs with the delivery of the trunk up to the costal marginso The diagnosis is made by noting the winging of the scapula and absence of the flexed limbs in front of the chesto Management: The management calls for the urgent delivery of the arms, first the posterior and then the anterior one.o The delivery of the arm may be accomplished by adopting any one of the following methods:a. Classicalb. LovsetLovset's maneuvero It is widely practiced in preference to the classical method of bringing down an arm. Advantages:1) Wider applicability-It can be applied even when the classical method becomes difficult.2) Intrauterine manipulation is nil.3) A single manipulation is effective to all types of displacement of the arms.4) General anesthesia is usually not needed.o Principles: Because of the curved birth canal, when the anterior shoulder remains above the symphysis pubis, the posterior shoulder will be below the sacral promontory. If the fetal trunk is rotated keeping the back anterior and maintaining a downward traction, the posterior shoulder will appear below the symphysis pubis.
Category:
Gynaecology & Obstetrics
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