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Internal podalic version & breech extraction

Second twin, or transverse lie at full dilatation.

Source: MSF · NHS GGC

Conditions

  • Fully dilated
  • Uterus relaxed, part not engaged
  • Empty bladder, anaesthesia, senior obstetrician

Steps

  1. Coned hand to the fundus; abdominal hand steadies uterus.
  2. Grasp one or both feet (through intact membranes) — feel the heel to be sure it’s a foot.
  3. Bring feet down, then rupture membranes.
  4. Complete breech extraction.
  5. Explore the uterus afterwards; antibiotics.
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