European journal of obstetrics, gynecology, and reproductive biology · 2022
Impacted fetal head during second stage Caesarean birth: A prospective observational study.
СтатьяНаблюдательное исследованиеНазвание и аннотация: Перевод пока не подготовлен
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Wyn Jones Nia, Mitchell Eleanor J, Wakefield Natalie, Knight Marian, Dorling Jon, Thornton Jim G, Walker Kate F
Аннотация
OBJECTIVE: To determine the incidence of, and complication rates from, impacted fetal head at full dilatation Caesarean birth in the UK, and record what techniques were used.
DESIGN: Prospective observational study using the UK Obstetric Surveillance System (UKOSS).
SETTING: 159 (82%) of the 194 UK hospitals with obstetric units.
POPULATION: All women who underwent second stage Caesarean birth in the UK between 1st March and 31st August 2019. Further information was collected on cases where a dis-impaction technique was used, or the operating surgeon experienced 'difficulty' in delivering the head.
METHODS: Prospective observational study.
MAIN OUTCOME MEASURES: Technique(s) used, maternal and neonatal outcomes.
RESULTS: 3,518 s stage Caesarean births reported. The surgeon used a dis-impaction technique or reported 'difficulty' in 564 (16%) of these. The most common dis-impaction techniques used were manual elevation of the head by an assistant through the vagina (n = 235) and a fetal "pillow" (n = 176). Thirteen babies (2%) died or sustained severe injury. Four babies died (two directly attributable to the impacted fetal head).
CONCLUSIONS: Difficulty with delivery of the fetal head and the use of dis-impaction techniques during second stage Caesarean sections are common but there is no consensus as to the best method to achieve delivery and in what order.
DESIGN: Prospective observational study using the UK Obstetric Surveillance System (UKOSS).
SETTING: 159 (82%) of the 194 UK hospitals with obstetric units.
POPULATION: All women who underwent second stage Caesarean birth in the UK between 1st March and 31st August 2019. Further information was collected on cases where a dis-impaction technique was used, or the operating surgeon experienced 'difficulty' in delivering the head.
METHODS: Prospective observational study.
MAIN OUTCOME MEASURES: Technique(s) used, maternal and neonatal outcomes.
RESULTS: 3,518 s stage Caesarean births reported. The surgeon used a dis-impaction technique or reported 'difficulty' in 564 (16%) of these. The most common dis-impaction techniques used were manual elevation of the head by an assistant through the vagina (n = 235) and a fetal "pillow" (n = 176). Thirteen babies (2%) died or sustained severe injury. Four babies died (two directly attributable to the impacted fetal head).
CONCLUSIONS: Difficulty with delivery of the fetal head and the use of dis-impaction techniques during second stage Caesarean sections are common but there is no consensus as to the best method to achieve delivery and in what order.