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Advanced Technical IVT

Nuchal hand

Fetal malpresentation where one or both hands are positioned behind the fetal neck during delivery, complicating vaginal birth.

Full Definition

A type of fetal malpresentation that occurs during delivery when one or both of the fetus's hands become positioned behind the neck (nuchal area), creating an obstruction that complicates vaginal delivery. This condition increases the diameter of the presenting part and can lead to arrest of descent, requiring specific maneuvers or operative intervention for safe delivery. Nuchal hand is more commonly associated with breech presentations but can occur with vertex presentations as well. Recognition and appropriate management are crucial to prevent birth trauma.

Usage

Usage note: Not to be confused with nuchal cord. Specify 'nuchal hand' rather than just 'nuchal' to avoid confusion with other nuchal presentations.

In Context

  • "Delivery was complicated by nuchal hand requiring specific maneuvers to disengage the arm." — Operative delivery report
  • "The resident failed to recognize the nuchal hand, leading to a prolonged second stage." — Clinical case review

Also known as

nuchal arm

Don't confuse with

nuchal cord compound presentation deflexed head

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