Seksio Sesaria dengan

Penyulit

Semester III

Pembimbing:
dr. H. Patiyus Agustiansyah, SpOG(K)

ARP 2013

Floating/High Head
Rotation of chin or occiput to the front is

possible by an application of forceps with the

pelvic curve anteriorly
Insert hand below foetal head and use in a
manner of shoe horn to scoop head out of
pelvis. Associated with fundal pressure this
method is quick and easy
after rupture of membrane allow some time to
descend the head towards incision by gravity
added with fundal pressure

Deeply Impacted Head

Deepen plane of anaesthesia, achieving

uterine relaxation
Head low position to dis-impact the foetal
head from pelvis along with upward pressure
on foetal shoulder by the operator.
While operators hand is inserted to lever out
of head, pressure by assistant on foetal
shoulder and an attempt to bring the chin
anterior can be made.

Deeply Impacted Head

An assistant using suitable aseptic precaution

may push foetal head upward from the

vagina.
If arm or shoulder has been extended from
uterine incision and other method are failed,
extraction may be achieved by Pathwardhan
or Modified Patwardhan manoeuvre

Deeply Impacted Head

In Patwardhan manoeuvre one armopposite

armtrunkone legother leg and finally

head are delivered in succession
In Modified Patwardhan manoeuvre one arm
same side leg buttock opposite leg
opposite arm and lastly head is delivered in
succession

Presentasi Bokong
Cara melahirkan bayi ada presentasi bokong :
Cari kaki bayi melalui luka insisi
Lahirkan seperti melahirkan bayi pada
presentasi bokong :
Lahirkan kaki hingga bahu kemudian lahirkan lengan
Tumpangkan bayi pada salah satu lengan

Letak Lintang
Bila bahu di arah fundus, cari kedua kaki

untuk melahirkan bayi seperti pada persalinan

sungsang atau bokong
Bila bahu kearah bawah maka diperlukan
insisi vertikal atau T untuk melahirkan kaki
dan kemudian lahirkan seperti persalinan
sungsang. Lakukan rekonstruksi dinding
uterus sebelum menutup dinding abdomen.

TERIMAKASIH

ARP 2013