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Reducing complications associated with a deeply engaged head at caesarean section: a simple instrument
Author(s) -
Singh Mandeep,
Varma Rajiv
Publication year - 2008
Publication title -
the obstetrician and gynaecologist
Language(s) - English
Resource type - Journals
eISSN - 1744-4667
pISSN - 1467-2561
DOI - 10.1576/toag.10.1.038.27376
Subject(s) - caesarean section , fetal head , medicine , obstetrics and gynaecology , obstetrics , audit , fetal monitoring , section (typography) , umbilical cord , general surgery , fetus , pregnancy , computer science , genetics , management , anatomy , biology , operating system , economics
Key content• There has been a disproportionate increase in caesarean section performed in the second stage of labour in the last few years. • Difficult delivery of the fetal head during caesarean section carries a higher risk of complications for both mother and baby. • The National Sentinel Caesarean Section Audit Report , published by the Royal College of Obstetricians and Gynaecologists recommends a consultant presence when caesarean section is performed at full dilatation.Learning objectives• The obstetrician needs to anticipate the possibility of difficult delivery of the fetal head during caesarean section. • Using an assistant to push the fetus can cause trauma, as the force required to push is uncontrolled. • The Foetal Disimpacting System® seems to be effective in elevating the fetal head when it is deeply engaged.Ethical issues• There is a need for more data before the fetal disimpacting device is adopted in routine obstetric practice. • Use of this device when preparing for an emergency caesarean section, for instance in a situation of umbilical cord prolapse, may be justified.Please cite this article as: Singh M, Varma R. Reducing complications associated with a deeply engaged head at caesarean section: a simple instrument. The Obstetrician & Gynaecologist 2008;10:38–41.