Management of impacted fetal head at caesarean section - Current practice and future development.

Worldwide, more than 1 in 5 women give birth by cesarean delivery, and at least 5% of these births are at full dilatation. In labour and at full dilatation, a caesarean section can be technically challenging and is associated with greater risks. The fetal head is lower and can be wedged within the maternal pelvis making it more difficult to deliver, a situation known as 'impacted fetal head'. This is associated with increased maternal and neonatal morbidity including uterine extensions, haemorrhage, fetal trauma and hypoxic ischaemic encephalopathy. This review explores the scope of the issue including the evidence for prevention and management of impacted fetal head, while highlighting key areas for future research.