Additional plain radiographic views such as
pelvic inlet, outlet and oblique Judet views may facilitate diagnosis.
R: Membranes are ruptured, and the patient qualifies for operative vaginal delivery under the rule of threes, defined in a 1982 article: "In an OA [occiput anterior] presentation, if the sum of the number of fifths of the fetal head palpated above the
pelvic inlet abdominally and the degree of molding of the fetal head palpated vaginally equals or exceeds three, then attempted operative vaginal delivery is likely to be unsuccessful and should be avoided."
Poor uterine tone lead to uterine inertia cause by hypocalcemia allow the uterus to fold in and permit part of the wall to move towards the
pelvic inlet. Straining then pushes the flaccid organ through the vagina (Jackson, 2004).
Bhatia, 2000 Lumbosacral Spine and
Pelvic Inlet Changes Associated With Pelvic Organ Prolapse.
Fetal presentation was corrected through repulsion and then grasping and pulling jaws of foal towards
pelvic inlet. A rope was placed on both of forelimbs and by using forced traction delivery of live foal was made.
Gynaeco-clinical examination explored a dry vaginal passage, expelled dead fetus's head hanging in vulva with compactly packed fetal hip in the dam's
pelvic inlet and diagnosed as hip lock condition.
Forced traction was applied to effect delivery of fetus, but was futile, hence further deep and detailed examination of fetus following its repulsion was done, revealing some additional lateral growth, simulating rib cage of another conjoined twin fetus, on right side of rib cage of fetus already in birth canal and it was locking the fetus at
pelvic inlet when traction was applied.