Personal experience in vertex presentation births, Rear variety

Abstract

In vertex presentations, Rear variety, if the work is slow delivery, it is convenient to practice a careful examination and whenever possible radiopelvicefalometría intra partum. When a disproportion pelvifetal checked with stenosis of the middle or lower narrow, large head and deflected, or Hayo dystocia irreducible contraction or cervical dystocia, should practice what segmental cesarean section. When there is no disproportion, it should test delivery, regulating contractions with oxytocics, IV drip of pitocin, sintocin and antispasmodic, Demerol, atropine,; systematically using the decubitolateral and knee-chest position. For termination of labor there are many methods that can be manual: internal version and extraction, flexor maneuver Hodge, manual rotation; and instruments: forceps, vacun extractor; it is advisable to use the one that works best for you, which in his hands safer. The forceps is still the best resource for solving the problem. When the head tends to rotate toward the sacrum, and when the plastic modeling is very pronounced, the detachment is done in OS. In other cases, which are the majority, OP, cephalic pole-Using curved forceps with tractor is broken; We use the Tarnier. OP rotation can be performed in a single time or two, as we practice personally, that first transformed to transverse and then OP. The vacun extractor has been used successfully to rotate the head in the later varieties. Maternal mortality and morbidity were higher earlier in the later varieties than previous, for the extension of work and higher operative frequency; the prognosis has greatly improved due to the better understanding we have of the pelvic morphology, the best clinical and radiological diagnosis of the imbalance, the more intelligent anticipation and timing of extraction operations, as well as the more secure domain of bleeding postpartum and infection. Mortineonatalidad stillbirth and, as a result of anoxia and obstetric trauma, currently they presented in subsequent varieties, almost only in cases of disproportion; when force maneuvers abdominally practice being indicated.