Cookies on this website
We use cookies to ensure that we give you the best experience on our website. If you click 'Continue' we'll assume that you are happy to receive all cookies and you won't see this message again. Click 'Find out more' for information on how to change your cookie settings.

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.

Original publication

DOI

10.1016/j.ejogrb.2022.03.004

Type

Journal article

Journal

European Journal of Obstetrics and Gynecology and Reproductive Biology

Publication Date

01/05/2022

Volume

272

Pages

77 - 81