Date post: | 17-Dec-2015 |
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Fetal Pillow at full dilatationMichael Beckmann Huda Safa
Background• Deeply engaged fetal head
• 1-2% of CS • Associated with adverse maternal
and neonatal outcomes
• RANZCOG guideline
• Fetal Pillow • Mater Health Services first unit in
Australia • 2 fetal deaths subject to Coronial
Investigation
Objective
Report the initial Australian experience with use of the Fetal Pillow
Methods• Retrospective cohort study
• Women who underwent CS at full dilatation • Between May 2013- March 2015 • Mater Mothers Hospitals, South Brisbane
• Data extracted from electronic maternity record
• Comparison• Cases where the FP method was used• Cases where the hand–push method was used • Maternal and neonatal outcomes reported
Results• 361 CS performed at full dilation
• FP-method 91 cases • Hand-push method 69 cases• Similar baseline characteristics
Fetal Pillow Hand-push P-value
Nullipara 82% 66% 0.15
Age 30y 31y 0.39
BMI 25 24 0.61
Gestation 40 40 0.54
Category 1 CS 49% 52% 0.95
Failed instrument 6% 4% 0.54
Results• Women in whom the FP-method was used
• Shorter post-partum length-of stay • Higher cord arterial pH • Less EBL• Other outcomes similar
Fetal Pillow Hand-push P-value
Apgar <7 @ 5 minutes 3% 6% 0.44
Intubated 0% 3% 0.10
Nursery admission 15% 25% 0.14
Cord arterial pH 7.24 7.19 0.02*
Mean EBL 273ml 403ml 0.03*
Blood transfusion 3% 3% 0.71
Angle extension 20% 34% 0.09
Post-partum LOS 78h 98h 0.01*
Conclusions• Initial findings
• confirm others experience • effective aid when deeply impacted fetal head • larger numbers are needed
• Clinician feedback universally positive
• Risk minimisation