Intrapartum bimanual tocolytic-assisted reversal of face presentation: Preliminary report

Objective: To design and conduct a mode of vaginal delivery for mentoposterior-presenting fetuses when cesarean delivery is not possible. Methods: Eleven orthodox Jewish parturients who refused cesarean delivery had intrapartum bimanual conversion of mentoposterior to occipitoanterior presentation, concomitant with ritodrine infusion in ten. Results: Excluding the first case, in which ritodrine was not administered, the maneuver was successful and vaginal delivery was achieved. Conclusion: This maneuver, performed with intravenous ritodrine tocolysis, might be an alternative mode of delivery in the presence of mentoposterior presentation when cesarean delivery is not possible. More experience is needed with this technique before it is performed routinely. (Obstet Gynecol 1994;84:146-8).