Maternal and Foetal Outcome of Impacted Foetal Head During Caesarean Delivery

Madhura D Mandlik1, Niranjan N Chavan2

1. Seth G. S. Medical College and King Edward Memorial Hospital, Mumbai, 2. LTMMC & LTMGH, Mumbai

Introduction

•LSCS rate in India as per NFHS-5 is 17% to 21.5%

•Second stage caesarean rate is 2.3%

•Foetal head may become wedged deep into the pelvis

•Additional manoeuvres are needed to deliver the foetal head

•Associated with maternal and foetal comorbidities

•In UK, 1 in 10 LSCS has an impacted foetal head

 

Objectives:

•To assess maternal and foetal outcomes of impacted foetal head encountered during caesarean delivery

•To determine the most common method of foetal head disimpassion and delivery

•To determine the decision to delivery time

 

Material and method:

•Descriptive, retro-prospective study

•Sample size (n)  : 30

•Inclusion criteria :

•Women for emergency LSCS

•Cephalic presentation

•Station 0 and below

•Cervical dilatation 5 cm or more

•Exclusion criteria : Deep transverse arrest, CPD, twins

•Study duration : May 2023 to November 2023

•Data Analysis : EpiInfo version 7.0.1.3

 

Conclusion: 

•Obstetric emergency

•Extension of uterine incision à The most common complication

•Oxytocin use, labour analgesia, and obesity ↑ incidence

•Clear guidelines and simulated training are essential

•Clinical judgement & experience are invaluable