Lower Segment Cesarean Section in Second Stage of Labor: Comparison of Patwardhan Method with Conventional Pushing Method (A 3-year Study)

JOURNAL TITLE: Journal of South Asian Federation of Obstetrics and Gynaecology

1. Prosun Bera
2. Kumudini Pradhan
3. Prakash Mishra
4. Lalmohan Nayak
5. Nihar R Bhoi
6. Tusar Mahapatra
7. Mitanjali Sethy
Publishing Year
Author Affiliations
1. com.mps.common.model.Contributor@5066c3d3 ,
2. com.mps.common.model.Contributor@18978bda ,
3. com.mps.common.model.Contributor@1502abb2 ,
4. com.mps.common.model.Contributor@b7ff3e6 ,
5. com.mps.common.model.Contributor@6de1c101 ,
6. com.mps.common.model.Contributor@490c5e3c ,
7. com.mps.common.model.Contributor@49d33394
Article keywords
LSCS, NICU, Patwardhan technique, Second stage of labor


Objective: To compare the fetomaternal outcome in Patwardhan technique vs “Push” method when lower segment cesarean section (LSCS) done in second stage of labor. Materials and methods: A prospective analysis of all cesarean sections performed in advanced labor with deeply waged head in VSS Medical College and Hospital, Burla, Odisha, India, during the years from April 2012 to March 2015. The cases were divided into two groups randomly; group I (deliveries by Patwardhan technique) and group II (Push method). Results: Out of 420 number of LSCS needed operation in 2nd stage of labor, in 129 cases, babies were delivered by Patwardhan technique and in 291 cases, delivery was conducted by Push method. 11.5% of cases among push/pull group had unwanted extension of uterine incision, whereas none had extension in Patwardhan group (p < 0.0001). Thirteen percent cases in group II, whereas 4.5% in group I required blood transfusion (p < 0.0001). The mean duration of hospital stay was not significantly different in both the groups (p = 0.06). There was requirement of NICU care in 23.2% cases in group I vs 28.8% in group II. Conclusion: In cases with difficult extraction of the impacted fetal head during cesarean section in second stage, Patwardhan technique is very useful in reducing fetomaternal morbidity and is the preferred method as compared to push and pull method.

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