Department of Obstetrics and Gynaecology, Women's and Babies' Division, Women's and Children's Hospital, Adelaide, South Australia, Australia.
Women's and Children's Health and The Robinson Research Institute, The University of Adelaide, Adelaide, South Australia, Australia.
Aust N Z J Obstet Gynaecol. 2023 Jun;63(3):360-364. doi: 10.1111/ajo.13635. Epub 2022 Dec 8.
Caesarean birth at full cervical dilatation can be technically challenging and may be associated with increased risks of maternal and neonatal morbidity, often secondary to difficulties in delivering a deeply impacted fetal head. The Fetal Pillow is a device designed to elevate an impacted fetal head out of the pelvis and reduce birth trauma.
To evaluate birth outcomes following the introduction of the Fetal Pillow at a tertiary maternity hospital.
This retrospective cohort study included all caesarean births at full cervical dilatation where the Fetal Pillow was utilised and compared with caesarean births where the Fetal Pillow was not used from October 2018 to December 2019. Maternal outcomes included uterine incision extension, blood loss, high dependency unit admission and postoperative length of stay. Neonatal outcomes included Apgar scores, resuscitation, cord arterial blood pH and lactate, nursery admission, birth trauma, jaundice and seizures.
There were 53 caesarean births where the Fetal Pillow was utilised and 48 where it was not. Baseline characteristics were similar between groups with mean maternal age across both groups of 30.4 (±5.3) years, mean gestational age at birth of 39.5 (±1.2) weeks and mean infant birth weight of 3543 (±441) g. There were no statistically significant differences between the two study groups for the maternal and neonatal outcomes considered.
There was no evidence that use of the Fetal Pillow to elevate an impacted fetal head during caesarean birth when cervical dilatation is >7 cm was associated with a reduced rate of adverse maternal and neonatal outcomes.
在宫颈完全扩张时行剖宫产术可能具有技术挑战性，并且可能与母婴发病率增加相关，这通常是由于难以娩出深陷的胎头所致。胎儿枕头是一种设计用于将深陷的胎头抬高离开骨盆并减少分娩创伤的装置。
评估在一家三级妇产医院引入胎儿枕头后分娩的结局。
这项回顾性队列研究纳入了所有在宫颈完全扩张时使用胎儿枕头的剖宫产术，并与 2018 年 10 月至 2019 年 12 月期间未使用胎儿枕头的剖宫产术进行比较。母亲的结局包括子宫切口延长、出血量、入住高依赖病房和术后住院时间。新生儿结局包括 Apgar 评分、复苏、脐动脉血 pH 值和乳酸水平、新生儿病房入院、分娩创伤、黄疸和癫痫发作。
有 53 例剖宫产术中使用了胎儿枕头，48 例未使用。两组的基线特征相似，两组产妇的平均年龄为 30.4（±5.3）岁，出生时的平均孕龄为 39.5（±1.2）周，平均婴儿出生体重为 3543（±441）g。在考虑的母亲和新生儿结局方面，两组之间没有统计学上的显著差异。
在宫颈扩张>7cm 时行剖宫产术时使用胎儿枕头抬高深陷的胎头，并没有证据表明与母婴不良结局发生率降低相关。
