Delivery of an impacted head during caesarean section. An easy and reliable manoeuvre: to assess adequate and safe hysterotomy and to control bleeding

"Push or pull” are the two methods by which an impacted head may be delivered during a caesarean section; the pull method is the one preferred. A manoeuvre is hereby described through which a deeply wedged head may be disengaged prior to hysterotomy. The success of this manoeuvre allows delivery of the head through a low uterine segment transverse hysterotomy. Its failure is an indication of reverse breech extraction to be performed through a longitudinal caesarean section; which to the Author’s experience proved to be less traumatic and easier to repair than an inverted T shaped or a very curved transverse LUS hysterotomy. To Authors experience, longitudinal hysterotomy when properly repaired is not an indication to tubal ligature. The routine use of this manoeuvre allows a quite bloodless caesarean sectio