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In obstetrics, a cephalic presentation or head presentation or head-first presentation is a situation at childbirth where the fetus is in a longitudinal lie and the head enters the pelvis first; the most common form of cephalic presentation is the vertex presentation, where the occiput is the leading part (the part that first enters the birth canal). [1]
External cephalic version (ECV) is a process by which a breech baby can sometimes be turned from buttocks or foot first to head first. It is a manual procedure that is recommended by national guidelines for breech presentation of a pregnancy with a single baby, in order to enable vaginal delivery.
Once the baby has been delivered placental management becomes an issue. In normal deliveries the contraction of uterus provides a powerful mechanism to control blood loss, however, in an abdominal pregnancy the placenta is located over tissue that cannot contract and attempts of its removal may lead to life-threatening blood loss.
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The average time from delivery of the baby until complete expulsion of the placenta is estimated to be 10–12 minutes dependent on whether active or expectant management is employed. [53] In as many as 3% of all vaginal deliveries, the duration of the third stage is longer than 30 minutes and raises concern for retained placenta. [54]
These include uterine ruptures, chronic pain, hemorrhages, and bladder injury. One of the more severe complications is placenta accreta, which can lead to a life-threatening hemorrhage and peripartum hysterectomy. [3] Complications the baby may face include cephalohematomas, hyperbilirubinemia, and intracranial hemorrhages.
Couvelaire uterus (also known as uteroplacental apoplexy) [1] is a rare but not a life-threatening condition in which loosening of the placenta (abruptio placentae) causes bleeding that penetrates into the uterine myometrium forcing its way into the peritoneal cavity. This condition makes the uterus very tense and rigid.
Usually the male doctor's job was to save the mother's life if, for example, the baby had become stuck on his or her way exiting the mother. Before the obstetrical forceps, this had to be done by cutting the baby out piece by piece. In other cases, if the baby was deemed undeliverable, then the doctor would use a tool called a crochet.