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The occurrence of a nuchal arm during vaginal breech delivery is a potentially traumatic event associated with high perinatal morbidity and mortality. This problem usually cannot be anticipated and must be overcome immediately on diagnosis during the second stage of labor. The results of a retrospective analysis of radiologic studies of 115 cases of term singleton breech deliveries are presented here. A nuchal arm in the first stage of labor was diagnosed in five cases, an incidence of 4.35%. Of four vaginal breech deliveries, one case resulted in severe handicapping neonatal trauma. We suggest that radiologic diagnosis of a nuchal arm in the first stage of labor should indicate abdominal delivery.

Cesarean sections performed for the delivery of the premature infant are known to be prone to dangers to the fetus, primarily due to contraction of the incised but as yet undelivered uterus upon the fetus, which thus entraps it. Reported is our technique for performing a cesarean section in prematurity, describing two simple yet helpful measures-halothane administered to the mother and controlled entrance to the amniotic sac, after having completed the whole uterine incision without rupturing the membrances. These measures are designed to avoid or at least, it is hoped, to reduce the occurrence of the previously mentioned severe complication.

A case is presented in which external vibratory acoustic stimulation performed on a term fetus produced severe prolonged bradycardia, necessitating emergency cesarean section delivery. The possible pathogenesis is discussed.