Zavanelli’s manoeuvre done in:
Correct Answer: Shoulder dystocia
Description: Ans: A (Shoulder dystocia) "Zavaneli manoeuvre is done in Shoulder dystocia. Here, the fetal head is flexed and the fetus is replaced within the uterus and therafter baby is delivered by emergency caesarean section" - Dutta Obstetrics 6th / 407In Deep Transverse Arrest (DTA), vaginal delivery' is found safe. Although ventouse, mannual rotation and forceps application is also applied.Caesarian section done if boby is big and pelivis is inadquate and craniotomy for dead bady- Dutta Obstetrics 6th /372Shoulder DystociaThe term is defined to describe a wide range of difficulties encountered in the delivery of the shoulders.Predisposing factors1. Fetal macrosomia2. Obesity'3. Diabetes4. Midpetvic instrumental delivery5. Postmaturity'6. Multiparity7. Anencephaly8. Fetal ascitesManagement principles : There are some Dos and DONTs for the management'DONTs'- (1) Do not be panicky (2] Do not give traction over baby's head (3) Do not apply fundal pressureDOSs'- (1) Call for extra help (2) Clear the infant's mouth and nose (3) Involve the anaesthesist and the paediatrician. (4) Perform a wide mediolateral episiotomy, if made earlierMe Roberts maneuver & Wood's maneuver are also used in Shoulder dystocia- Dutta Obstetrics 6th/407-08Fundal pressure is avoided as it causes further impaction of the shoulder. Moreover it caused neurologic and orthopedic damage.
Category:
Gynaecology & Obstetrics
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