During internal podalic version and breech extraction for the second twin, the operator encounters difficulty delivering the after-coming head. The Mauriceau-Smellie-Veit maneuver is attempted. Which of the following correctly describes this maneuver?

• A The operator makes an episiotomy to increase the pelvic outlet diameter
• B The operator rotates the fetus 180 degrees to bring the feet into the vagina
• C The operator applies Piper forceps to the after-coming head
• D The operator places two fingers in the fetal mouth and flexes the head while an assistant applies suprapubic pressure ✓

Explanation

The Mauriceau-Smellie-Veit maneuver involves the operator placing two fingers on the fetal maxilla (or in the mouth) to flex the fetal head while an assistant applies suprapubic pressure on the maternal abdomen, guiding the head through the pelvis. It is the standard first maneuver for delivering the after-coming head in breech. Piper forceps are used adjunctively after the body is delivered but are not the maneuver itself. Internal podalic version involves bringing the feet down, which is a separate procedure.

Reference: Williams Obstetrics, 26th ed.

High-yield for: NEET PGINI-CETNExTFMGEUSMLEPLABMRCP

Written and medically reviewed by the StethoPrep medical team.