摘要：Objective: To compar. mater.al and neonatal mor.idity associated with two methods to extr.ct the impacted fetal head dur.ng Cesar.an deliver.. Study design: We r.tr.spectively analyzed cases with difficult extr.ction of the impacted fetal head dur.ng Cesar.an section. We compar.d mater.al and neonatal outcomes between cases that wer. deliver.d by head extr.ction following pushing thr.ugh the vagina (“ push” method) and those that wer. deliver.d by the r.ver.e br.ech technique (“ pull” method). r.sults: We r.viewed 3105 Cesar.an section r.por.s. Difficult extr.ction necessitating the “ push” or.“ pull” methods was noted in 48 (1.5% ) instances. Women that wer. deliver.d by the “ pull” method had significantly lower.r.te of postpar.um fever.(5% ver.us 46% ; odds r.tios, 0.06; 95% confidence inter.als, 0.007- 0.51) and extensions of the uter.ne incision (15% ver.us 50% ; odds r.tio, 0.17; 95% CI, 0.04- 0.74) compar.d to those that wer. deliver.d by the “ push” method. Neonatal outcomes wer. good in all cases. Conclusions: In cases with difficult extr.ction of the impacted fetal head dur.ng Cesar.an section, “ pull” method may r.sult in lower.mater.al mor.idity compar.d to the tr.ditional “ push” method.

摘要：Objectives The pur.ose of this study was to compar. the efficacy of cer.ical r.pening with 2 Foley catheter.balloon volumes. Study design Pr.gnant women admitted for.induction of labor.with a ter. singleton gestation wer. r.ndomly assigned for.cer.ical r.pening by a balloon inflated with 30 mL or.80 mL of ster.le saline. r.sults Two hundr.d and thr.e women wer. included in the analysis. r.pening of the cer.ix with the lar.er.balloon volume was associated with a significantly higher.r.te of postr.pening dilatation of 3 cm or.mor. (76.0%vs 52.4%, P <.001). In pr.mipar.us women, the lar.er.balloon volume r.sulted in a significantly higher.r.te of deliver.es by 24 hour. (71.4%vs 49%, P <.05), and a significantly less r.quir.ment of augmentation with oxytocin (69.3%vs 90.4%, P <.05). Conclusion r.pening of the unfavor.ble cer.ix in pr.mipar.us women with a Foley catheter.balloon inflated with 80 mL pr.vided effective mor. dilatation, faster.labor. and decr.ased need for.oxytocin than with a balloon inflated with 30 mL of ster.le saline.