2.3. PRECONDITIONS AND CONTRAINDICATIONS FOR SYMPHYSIOTOMY
Engagement of the Fetal Head: In order to reduce the risk of complications, symphysiotomy should only be performed with an engaged fetal head. Vaginal examination for fetal head engagement when labour is obstructed could be misleading, as the presence of marked caput and moulding may obscure the true station of the fetal head. Using the classification described by Philpott (1973) of dividing the fetal head into fifths and describing descents as the number of fifths of fetal head that have passed through the brim of the maternal pelvis can be helpful in this circumstance (26). Symphysiotomy should only be undertaken only if less than two-fifths of fetal head is palpated above the maternal pelvic brim. See Figure 1.
(forget procedure details lol it's all I could find on google on my phone)