A comparative study between Patwardhan technique and push & pull method in women undergoing second stage of labor

Abstract

Introduction: Obstructed labor with the fetal head impacted in the pelvis is an obstetric complication that requires caesarean delivery with skilful handling in an organized manner to avoid serious maternal and neonatal morbidity. The present study was undertaken to compare the Patwardhan technique with push and pull methods and also to evaluate the safety of Patwardhan technique. Material & methods: Study based on a total 90 pregnant women, of age 18 – 35 years with singleton pregnancy in second stage of labor with deeply impacted head, cases examined in labor room who gave consent and fulfilled inclusion criteria including inpatient admissions and referral randomly allocated in three groups 30 each.1. Patwardhan technique. 2. Push Technique 3. Pull technique. Results: Age, gestational age and duration of labor of the subjects in three were similar. There was significantly less incidence of uterine incision extension to either side, board ligament hematoma, intra-operative blood loss and traumatic Postpartum hemorrhage in subjects undergoing Patwardhan’s technique. With regards to neonatal outcome, wound infection, foetal injury and mean duration of hospital stay were significantly less in Patwardhan’s technique. Birth weight and APGAR scores were similar in all groups. Conclusion: There was less incidence of maternal and foetal morbidity in Patwardhan’s technique which makes it a preferred choice for management during second stage of labor