A 20 year old full-term primigravida is brought to the casualty with labour pains for last 24 hours and a hand prolapse. On examination, she has pulse 96/min, BP 120/80 mm Hg, and mild pallor. The abdominal examination reveals the uterine height at 32 weeks, the foetus in transverse lie and absent foetal heart sounds. On vaginal examination, the left arm of the foetus is prolapsed and the foetal ribs are palpable. The pelvis is adequate. What would be the best management option ?

Question

Quizplus · Accepted Answer

Given the situation of a dead fetus in a transverse lie with a prolapsed arm and the fact that the pelvis is adequate, decapitation and vaginal delivery is the most appropriate management. This approach avoids the risks associated with major surgery in a case where the fetus has already demised and the maternal condition allows for a vaginal procedure.

A 20 Year Old Full-Term Primigravida Is Brought to the Casualty