Symphysiotomy for the trapped aftercoming parts of the breech: a review of the literature and a plea for its use

Aust N Z J Obstet Gynaecol. 1990 Feb;30(1):1-9. doi: 10.1111/j.1479-828x.1990.tb03185.x.


The most dreaded complication of vaginal breech delivery is entrapment of the aftercoming head. When this is due to disproportion, persistent attempts at vaginal extraction are likely to result in a dead or damaged baby. A largely unknown solution in this desperate predicament is to surgically enlarge the pelvis by means of a symphysiotomy. A review of the literature shows that symphysiotomy performed to free the trapped aftercoming head will save at least 80% of babies if the procedure is performed without delay. Every obstetrician should be prepared to perform a symphysiotomy if the aftercoming head is trapped.

Publication types

  • Review

MeSH terms

  • Breech Presentation*
  • Cesarean Section
  • Delivery, Obstetric / methods*
  • Emergencies
  • Female
  • Humans
  • Obstetric Labor Complications / etiology
  • Obstetric Labor Complications / surgery*
  • Pelvimetry
  • Pregnancy
  • Symphysiotomy / adverse effects
  • Symphysiotomy / instrumentation
  • Symphysiotomy / methods*
  • Urinary Catheterization