Approach to rescue maneuvers for extracting the fetus with a deeply impacted head at cesarean birth

* Fetal extraction should always be possible with extension of the incision. Other options that may be successful have not been validated in large numbers of patients but are reasonable options as well. These include Patwardhan technique (shoulders first method) or use of fetal head elevators for extraction, or use of a disimpacting system (eg, fetal pillow) prior to beginning the extraction. Use of these options depends on clinician training, preference, and availability of equipment. For more information, refer to UpToDate content on management of deeply impacted fetal head at cesarean birth.