PL.54 The Fetal Pillow (FP): A Novel Intervention to Reduce Maternal and Fetal Complications in Caesarean Sections at Full Dilatation (CSFD)

Abstract

CSFD have an increase in maternal and fetal complications. There is an increase in post-partum haemorrhage, blood transfusions, and increase in hospital stay for mothers and NICU admissions. One method of reducing morbidity relating to CSFD is the FP, a silicone balloon inserted vaginally prior to CSFD resulting in a 3–4 cm upward displacement of the fetal head. A retrospective study was performed analysing FP use in 16 patients undergoing CSFD, compared to 18 patients undergoing CSFD without FP use. The aim was to establish whether the FP reduces complications in CSFD. Average operating time using FP was 41.6 minutes, and 70 minutes without. Average blood loss using FP was 698 mls, and 829 mls without. Uterine extensions were 31% in FP, and 33% without. The group without the use of FP saw 2 cases of blood transfusion, one had bladder damage intraoperatively, another required HDU admission, two had maternal pyrexia, and one required re-admission. This group also had two NICU admissions. 6% of surgeons reported fetal head delivery difficult using FP, and 39% without. 50% of surgeons said delivery of fetal head was easy using FP, and 39% without. The FP seems to aid delivery of the impacted fetal head at CSFD. In the FP group there was reduction in average operating time, intra-operative trauma, need for transfusions, and blood loss. There was no maternal pyrexia, no maternal admissions to HDU, and no NICU admissions. These results are very encouraging to assess the routine use of fetal pillow in CSFD.