OBSTETRIC MANOEUVRES

ByDr.Sulake Fadhil Abbas

OBSTETRIC MANOEUVRES1)Retropulsion (repulsion)2) Version3) Rotation4) Extension and adjustment of the extremities

Retropulsion (Repulsion)Retropulsion means pushing the fetus cranially from the vagina (and the bony pelvic canal) towards the uterus. Repulsion may be accomplished by the operator's arm or by the use of a crutch or repeller. In anterior presentation, the crutch or hand of the operator is usually placed on the fetus between the shoulder and chest or across the chest beneath the neck. In the posterior presentation, the hand or crutch is placed in the perineal region over the ischial arch.

Repulsion is difficult or impossible in the recumbent animal resting on its sternum as the abdominal viscera are pushing the fetus back toward the pelvis. If the animal is recumbent, it should be placed on its side with its four legs extended.

Repulsion is difficult or impossible in the recumbent animal resting on its sternum as the abdominal viscera are pushing the fetus back toward the pelvis. If the animal is recumbent, it should be placed on its side with its four legs extended.

VersionVersion means alteration of transverse or vertical to longitudinal presentation. This is done most often in the mare in transverse presentation of the fetus. The version is usually limited to 90 degrees and by repulsion on one end of the fetus and traction on the other, the transverse presentation is changed to a longitudinal presentation. If possible, the fetus should be turned into a posterior presentation; this prevents the head and neck from complicating the delivery.

VersionVersion means alteration of transverse or vertical to longitudinal presentation. This is done most often in the mare in transverse presentation of the fetus. The version is usually limited to 90 degrees and by repulsion on one end of the fetus and traction on the other, the transverse presentation is changed to a longitudinal presentation. If possible, the fetus should be turned into a posterior presentation; this prevents the head and neck from complicating the delivery.

RotationRotation entails alteration of the position of a fetus by moving it around its longitudinal axis: for example, from the ventral to dorsal position. It is more often required in horses than in cattle and is much more easily effected on the responsive live fetus, which may be readily rotated by digital pressure on the eyeballs, protected by the lids; this causes a convulsive reaction, and slight rotational force then completes the manoeuvres

In dorso-ilial position, repulsion is usually not necessary but may be helpful. Lubrication of the birth canal caudal and downward traction on the extremities, and rotation of the fetus with the operator's arm in the birth canal readily corrects this abnormal position.If the fetus is in a dorso-pubic position it should be repelled out of the pelvis, leaving the limbs in the pelvic cavity, chains are fastened to the fetlock and cross traction is applied by two assistants.

Depending upon which way the fetus is to be rotated, one leg is pulled at first upward, then horizontally to the left or right and then downwards, while the other leg is being pulled underneath the first leg downward and obliquely toward the right or left.

Rotation using torsion Fork

Anterior presentation , Dorso pubic position

Posterior presentation, dorso pubic and rotation by Fork

Carpal flexion

Treatment The fetus is repelled and the flexed carpus pushed upwards and forwards from the obstetrician so that the missing foot can be found more readily. The foot is cupped in the hand and brought carefully up into the pelvis

The obstetrician's hand is advanced down the limb towards the carpal joint. The limb is grasped and brought up into the carpal flexion position, and then the foot is brought into the pelvis.

The obstetrician's hand is advanced down the limb towards the carpal joint. The limb is grasped and brought up into the carpal flexion position, and then the foot is brought into the pelvis.

Shoulder flexion

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