Sometimes during the management of labor with pelvic presentations, this complication arises, as the throwing of the fruit handles . There are three degrees of casting the fetus's handles. If this complication occurs, use classical manual help. Manual assistance begins with the release of the fetus's handles; by this time the fetus must be born to the lower angle of the anterior scapula.
The first always release the back handle, because the crotch on the side of the crotch is more accessible. To do this, both shanks of the fetus are grasped with one hand and guide the trunk up and to the side until the legs are located parallel to the inguinal bend opposite the side of the handle that is being released. After that, two fingers of the other hand are inserted into the birth canal from the fetal back and without pressing on the elbow fold, withdraw the back handle. Simultaneously with the withdrawal of the rear handle, the front is often born on its own. When this does not happen, the front handle is transferred to the back, carrying the fetus back under the bosom, and released by the method described above.
For the release of the head, the Moriso-Levre method is used. After birth, the baby's handles are "mounted" on the forearm of the hand, with the same name as the position (in the first position - the left forearm, the second for the right arm), insert the index finger of this hand into the baby's mouth facing the right or left pelvic wall, and carefully press his chin to his chest. Fork-shaped bending index and middle fingers of the other hand, placed on the sides of the neck, on the shoulders of the baby, the extracted head towards the birth canal (the leading axis of the pelvis). It is better if the assistant then presses (gently) on the head from above the bosom. When the suboccipitary fossa approached the pubic arch and the mouth appeared in the genital gaps, the fetus's body is lifted up and the chin, face, forehead and crown are lifted above the crotch. In this case, the largest size of the eruption of the head will be a small or medium oblique (9-10 cm).