The impacted foetal head at caesarean section: incidence and techniques used in a single UK institution

2019 ◽  
Vol 39 (7) ◽  
pp. 948-951 ◽  
Author(s):  
Alexandra Rice ◽  
Graham Tydeman ◽  
Annette Briley ◽  
Paul T. Seed
2018 ◽  
Vol 6 (1-2) ◽  
pp. 62-66
Author(s):  
Dewan Shahida Banu ◽  
Rowshan Hosne Jahan ◽  
Faiza Chowdhury ◽  
Zinat Begum ◽  
Shahnaz Akter Jahan ◽  
...  

Objective: This prospective study was carried out to see the effect of engagement of foetal head at term in primigravidae women. Materials and Methods: The study was conducted in the Department of Obstetrics & Gynaecology, Sir Salimullah Medical College & Mitford Hospital (SSMC & MH), Dhaka from June, 2006 to December, 2006. The study included 1440 women who were admitted in the hospital during the above mentioned period. All women were examined to see the engagement of foetal head by the rule of 5 at or after 38 weeks pregnancy. Of them, 262(18.2%) presented with engagement of foetal head and 1178(81.8%) without foetal head engagement. Main outcome measure was the effect of engagement of foetal head at term in primigravidae women. Foeto-maternal outcomes were recorded by clinical observation. Result: No significant differences were found in terms of demographic and anthropometric characteristics (like age, height and weight) between primigravidaewomen who had engaged foetal head and women who did not have foetal head engaged (p = 0.969; p = 0.258 and p = 0.139). Three-quarters (74.96%) of the patients at presentation were in labour and the rest were not in labour. Duration of labour was significantly higher in non-engaged group compared to those who had foetal head engaged.The incidence of non-engagement of foetal head in nulliparous women at or after 38 weeks of pregnancy was 81.8%; but only 11.5% of them had cephalo-pelvic disproportion (CPD). The incidence of vaginal delivery in the non-engaged and engaged group was 36.9% and 66.1% respectively. Most of the patients underwent caesarean section due to foetal distress and indications other than CPD. Conclusion: The findings of the study suggest that the obstetricians should take a conservative attitude and a non-engaged foetal head at term in a primigravid woman should not by itself be an indication for caesarean section. Ibrahim Card Med J 2016; 6 (1&2): 62-66


2017 ◽  
Vol 38 (1) ◽  
pp. 146-147
Author(s):  
Shigeki Matsubara ◽  
Hironori Takahashi ◽  
Rie Usui

Author(s):  
Katie Cornthwaite ◽  
Rachna Bahl ◽  
Erik Lenguerrand ◽  
Cathy Winter ◽  
John Kingdom ◽  
...  

Author(s):  
Bhagyashree A. ◽  
Julie Thomas ◽  
Shobha N. Gudi

Background: Considering the high rate of caesarean section, and the difficulty during delivery of the floating foetal head even by the most experienced obstetrician, the use of vacuum has been described. The present study was undertaken with the hypothesis that, vacuum assisted foetal head delivery during caesarean section is safe and effective without increasing maternal and neonatal complications. The outcomes enumerated by the limited literature available need to be evaluated before it is used routinely.Methods: A prospective, randomized, comparative, cross sectional Hospital based study was conducted at St. Philomena’s Hospital, Bangalore. Every woman randomized for the study received either conventional method or ventouse extraction of fetal head at cesarean section. 200 women were enrolled into the study with 100 in each arm. The primary outcome measures were percentage of successful extractions and I-D interval. The secondary outcome measures were, uterine incision extension, estimated blood loss, Apgar scores, neonatal hyperbilirubinemia and neonatal scalp or head injury.Results: Successful extraction was done in 89 % and 98 % cases in manual and vacuum extraction cases. (p =0.0184). U-D interval in the manual extraction group was 66.59±4.64 seconds and in the Vacuum extraction group it was 56.06±3.46 seconds (P<0.001). The mean pre-delivery hemoglobin levels in group I was 11.6±0.73 compared to 11.36±0.49 gm% in group II. The mean post-delivery hemoglobin levels in group I was 10.29±0.79 compared to 10.21±0.53 gm% in group II (p <0.001). The uterine incision extensions were significantly higher in manual extraction group, 18 of the 100 women (18 %), whereas only 2 of the 100 women in vacuum group had uterine extensions (p=0.0002).Conclusions: Authors conclude that the routine use of ventouse is safe and effective for mobile fetal head extraction at cesarean section.


Author(s):  
Nicola Vousden ◽  
Graham Tydeman ◽  
Annette Briley ◽  
Paul T. Seed ◽  
Andrew H. Shennan

2018 ◽  
Vol 26 (2) ◽  
pp. 122-125
Author(s):  
Mukti Rani Saha ◽  
Nahid Yasmin ◽  
Afzalunnessa Chowdhury ◽  
Shahrin Ahmed ◽  
Kamrunnahar Sweety ◽  
...  

Objective: To determine the causes of high foetal head and their relative frequencies in primigravidae presenting at term and to determine the proportion of these patients undergoing lower segment caesarean section or vaginal delivery. Design: A descriptive study.Place and duration of study: The study was carried out at Mugda Medical College Hospital from March 2017 to June 2017.Materials and Methods: A total of 50 primigravidae patients presenting at term and having a single pregnancy were randomly selected. On the basis of history, Physical examination and abdominal ultrasonography, patients having a high foetal head were recognized and their causes documented.Results: Out of 50 primigravidae, with high foetal head there was foetal malpresentation 17(34%), Cephalopelvic disproportion 13(26%) , Foetal distress 12(24%). Lower segment caesarian section was the management of choice in more than half of the patients with high foetal head.Conclusions: Foetal malpresentation & Cephalopelvic disproportion were the major cause of high foetal head in this study and lower segment Caesarean section was the mode of delivery in more than half of the patients with high foetal head.J Dhaka Medical College, Vol. 26, No.2, October, 2017, Page 122-125


2014 ◽  
Vol 8 (4) ◽  
pp. 42-44
Author(s):  
Janusz Kubicki

In the Medieval Times every third woman died during labour. The labour was assessed by uneducated women called ‘wise crones’, therefore, the procedure was called ‘croning’. It was not until Renaissance, when men were accepted as obstetricians. Then, the medics who were familiar with the anatomy joined to the profession along with well-educated surgeons who introduced a number of obstetric procedures, most of which have already been forgotten for a long time. There were two key moments in the development of modern obstetrics, namely, the introduction of forceps delivery by Chamberlane and Palfyn and the execution of the Caesarean section (C-section). In the case of breech presentation, the use of breech hooks and Wincle-Martin-Wiganda procedure were completely withdrawn along with external rotations. Only twofnger rotation, in the case of premature labour and incomplete cervical dilatation, is still used. Internal rotations, in the cases of complete dilatation, are performed only during the delivery of the second baby in twin pregnancy when the second foetus remains in horizontal position, after the delivery of the frst twin. One of the most signifcant moments in obstetric history was also the procedure performed by a midwife Justyna Siegemundin who turned the foetus in the uterus holding its foot with the use of a special obstetric tape. The procedures of craniotomy (reducing the foetal head size), cleidotomy (reducing the foetal shoulder girdle size by cutting the collarbone), exenteratio (reducing the foetal trunk size) or decapitation (cutting of the foetal head) are never used any longer. The procedures of symphysiotomy (cutting the symphysis) or Schuhardt’s extensive uterine muscle incision have also been suspended. Last but not least obstetric procedure, which is not used contemporarily, is the Fritsch’s grip used to stop atonic postpartum haemorrhage. Keyword: history, caesarean section, forceps, rotations/versio


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