DOI: http://dx.doi.org/10.18203/2320-1770.ijrcog20164630

Comparative study of vectis versus manual method for extraction of fetal head during lower segment cesarean section

Priyanka HK, Madhavi Yeddala, Vimala KR, Shailaja N., Bhat BS, Krishna L.

Abstract


Background: Delivery of fetal head through uterine incision is often the major technical problem during low transverse cesarean section when the presenting part is unengaged. Techniques to deliver head under special circumstances are traumatic to both mother and fetus. This study aims to establish the role of vectis in extraction of fetal head during lower segment cesarean section (LSCS) and to assess associated difficulties or untoward effects of use of vectis over manual method.

Methods: The study was undertaken in PESIMSR, Kuppam, Andhra Pradesh over two years. Vectis was used in extraction of fetal head in LSCS in 100 cases of full term pregnancy and maternal and neonatal outcomes were compared with 100 cases of manual extraction.

Results: Incision-delivery time interval was similar in both vectis and manual extraction method (p value of 0.390). Vectis group did not require any fundal pressure for extraction of head where as 100% of women in manual extraction group required fundal pressure (p value: <0.001) which is statistically significant. The length of abdominal incision for majority of cases in vectis group was smaller and statistically significant compared to manual extraction group (p value of 0.001). Neonatal outcomes were similar in both the groups.

Conclusions: As per our study, usage of vectis has shown significant advantage in reducing maternal discomfort caused due to fundal pressure and length of abdominal incision required, with negligible difference in neonatal and other maternal outcomes in comparison to manual method of extraction.


Keywords


Fundal pressure, Manual extraction, Maternal outcome, Neonatal outcome, Vectis

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References


de Rezende J. Cesarean sections, perfecting the technique and standardizing the practice: an analysis of the book Obstetrícia. 2016;23(1).

Nargolkar SM. Hay’s forceps, Penham, Manila, Philippines. pp. 218-230, 1991.

Studd J. Progress in obstetrics and Gynecology, first edition. 2000;8:107.

Barton's forceps: An effective aid in cesarean deliveries by John W Larsen Jr MD, Melissa Brunner MD, Sarah Gloria Obican. 2011.

Ackerknecht, Erwin H. A Short History of Medicine, Baltimore: The Johns Hopkins University Press, 1982.

Bryan C. Murless, Lower Segment Cesarean Section-A New Head Extractor: British Medical Journal. 1948.

Levy R, Chernomoretz T, Appelman Z, Levin D, Hagay ZJ. Head pushing versus reverse breech extraction in cases of impacted fetal head during Cesarean section. Eur J Obstet Gynecol Reprod Biol. 2005;121(1):24-6.

Hadalagi NM, Rashmi MB. Comparative study of ventouse versus conventional method for extraction of floating head during lower segment caesarean section. Jour Resea Obstet Gynec Infert. 2015;1(1):5-8.

Bellad MB, Koli P. Is Vacuum - assisted Delivery a Safer Option for Delivering a Floating Head at Cesarean Section? Jour Perinat Neona care. 2011;12(2):51-3.