Assisted delivery of mobile fetal head: a comparison of forceps, vaccum and assisted manual extraction of head at caesarean section

Authors

  • Sujata Swain Department of Obstetrics and Gynecology, S. C. B. Medical College Cuttack, Odisha, India http://orcid.org/0000-0002-9235-8952
  • N. Sagarika Department of Obstetrics and Gynecology, S. C. B. Medical College Cuttack, Odisha, India
  • Rabi N. Satpathy Department of Obstetrics and Gynecology, S. C. B. Medical College Cuttack, Odisha, India
  • Purna C. Mahapatra Department of Obstetrics and Gynecology, S. C. B. Medical College Cuttack, Odisha, India

DOI:

https://doi.org/10.18203/2320-1770.ijrcog20174063

Keywords:

Caesarean Section, Forceps, High floating/mobile fetal head, U-D interval, Vacuum assisted delivery

Abstract

Background: Difficult fetal extraction occurs in 1-2% of caesarean deliveries. Either forceps or a vaccum device is often used to assist in delivery of the fetal head in cesarean section in high floating/mobile fetal head.  This study compare the safety (for mother and fetus) and efficacy of forceps and vacuum assisted delivery of high floating/mobile fetal head with the traditional method of manual extraction at caesarean section.

Methods: The sample size included 100 cases of LSCS with manual extraction of fetal head, 100 cases of LSCS with forceps assisted extraction of fetal head and 100 cases of LSCS with vacuum assisted extraction of fetal head.

Results: Application of fundal pressure was required in all cases of manual extraction group, in 51 cases of forceps extraction group. None of the cases of vacuum extraction group required application of fundal pressure. The U-D interval in manual extraction group was 90.56±4.91 seconds, in forceps extraction group was 70.2±5.02 seconds and in the vacuum extraction group it was 62.3±2.03 seconds. In the manual extraction group, there was an estimated blood loss of 428±69.38 ml, 579±97.22 ml of estimated blood loss was present in forceps extraction group and in the vacuum extraction group it was 454±66.92 ml.

Conclusions: This study reveals that with use of vacuum in CS for delivery of floating head, is superior than application of forceps and manual delivery in relation to time, blood loss and fundal pressure without any adverse effect on neonates and maternal complication.

References

Levy R, Chernomoretz T, Appleman Z. Head pushing versus reverse breech extraction in cases of impacted fetal head during cesarean section. Eur J Obstet Gynecol Reprod Biol. 2005;12:24.

Sritippayawan S, Chantrapitak W. Assisted delivery of high floating fetal head: a comparison of vacuum-assisted delivery with manual extraction. Asian Biomed. 2011;5:699-703.

Hankins GDV, Clark SL, Cunningham FG, Gilstrap LC. Operative Obstetrics, Norwalk: Appleton and Lange;1995:318.

Ambwani BM. Primigravida with floating head at term or onset of labour. Internet J Gynecol Obstet. 2003;3(1).

Arad I, Linder N, Bercovici B. Vacuum extraction at cesarean section neonatal outcomes. J Perinatal Med. 1986;14:137-40.

Banu F, Pandit U, Ahmad S, Singh G. Effectiveness of vacuum extraction during cesarean section: A pioneer pilot study. SJMPS. 2016;2(10):4.

Iqbal S, Sumaira S. Outcome of primigravida with unengaged versus engaged fetal head at term or onset of labour. Biomedica. 2009;25:159-162.

Khurshid N, Sadiq F. Management of primigravida with unengaged head at term. PJMHS. 2012;6(1):36-9.

Poordast T, Tahereh T, Athar R, Fatemeh SN, Elham A. Vacuum extraction in cesarean delivery: an analysis of maternal and neonatal outcomes. Int J Develop Res. 2016;06(7):8656-8.

McQuivey RW, LaPorte V, Vecca A. Vacuum assisted delivery of the fetal head at cesarean section. In 1st Beijing International Conference on Obstetrics and Gynecology, Beijing; 2005:7-10.

Downloads

Published

2017-08-28

Issue

Section

Original Research Articles