External Pop-Out Technique Versus Classic Head Extraction During Cesarean Section
External Pop-Out Technique Versus Classic Head Extraction During Cesarean Section
Caesarean section is one the most common operations worldwide, its rates are globally
 increasing. A multitude of efforts had been done aiming at reduction of Caesarean section
 related maternal morbidities; most of them are related to technical modifications of how to
 open and how to close the abdominal and uterine incisions . The comparative studies of blunt
 versus sharp extension of the uterine incision showed a reduction of the incidence of
 unintended extension from 8.8% to 4.8% .

 The vulnerability of the lower uterine segment for tears are related to stage of labor. The
 frequency of unintended extension was reported to be 15.5%, and 35.0% in cases operated in
 first and second stages of labor respectively.

 The original techniques of fetal head extraction entail the introduction of the obstetricians
 hand or other instruments into the lower uterine segment . This puts the lower uterine
 segment at risk of damage and incision extensions with its consequences of increased blood
 loss, increased operative time, infection adhesions and blood transfusion. Adherence to the
 available the generated good quality evidence bases practice in Caesarean section is
 anticipated to decease such morbidities.

 The idea of the present technique was derived from the fact that during vaginal delivery the
 main task of obstetrician is to support the perineum while the fetal head extends to get out
 through birth canal.
Inclusion Criteria:

 -  single fetus

 -  more than 37 weeks of gestation

 -  elective Caesarean section

 Exclusion Criteria:

 -  non-cephalic presentation

 -  placenta previa

 -  hydrocephalus

 -  Multiple pregnancy