Decapitation is an operation in which the head is separated in the region of the cervical vertebrae from the trunk of the fetus, followed by their removal through the natural birth canal.
Indications: the transverse position of the fetus.
Conditions for decapitation:
- Full opening of the uterine throat;
- Accessibility of the fetal neck;
- Pelvic dimensions, sufficient for passage of the fetus.
The necessary tools: a Brown hook, Zybold's scissors or Phenomenov's, Muzo's forceps.
The operation is necessarily performed under anesthesia. Before the operation, the bladder should be emptied.
The technique of the operation consists of three stages:
The first stage is the introduction and placement of the decapitation hook. It consists of three moments:
1. Capture the handle, dropped by the assistant and drawing it away, opposite to where the head is; If the handle does not fall out, the operation starts from the second moment.
2. Introduction to the vagina of the hand and delight in the neck of the fetus.
3. Entering and placing the decapitation hook.
The second stage is proper decapitation. First, by turning the hook by 90 °, cervical vertebrae are broken, then under the control of the inner hand the soft parts of the fetal neck are cut with scissors. In this case, the decapitation hook is pulled up to the exit from the vagina.
The third stage is the extraction of the dissected fetus. Pulling the trunk by the handle, it is relatively easy to remove it.
When the head is withdrawn, the last assistant is fixed to the entrance to the small pelvis with external methods, after which the mirrors are inserted into the vagina, the head is grasped with Myso forceps and begins to be extracted. If possible, it is withdrawn by manual methods. In the event of difficulties during the removal of manual techniques, the head is perforated with subsequent exceriation and cranioclasia.