Impacted Fetal Head at Cesarean Delivery

( J Clin Anesth . 2024;99:111598. doi: 10.1016/j.jclinane.2024.111598) Instances of the fetal head becoming lodged in the pelvis during cesarean delivery (CD) and not being able to deliver the head without surgical intervention are known as cases of impacted fetal head (IFH). This is considered an obstetric emergency and occurs in between 18% and 63% of emergency CDs. IFH has been associated with direct trauma to both mother and fetus, prolonged fetal delivery time, and hypoxia, as well as skull fractures, hypoxic brain injury and other fetal or maternal morbidities. In these cases, anesthesiologists have a key role in minimizing adverse effects and managing surgical complications, though many are not trained in IFH. This article is a narrative review focusing on the incidence, risk factors, management, and complications of IFH from the point of view of anesthesiologists, including surgical complications.