S.R Cephalic Extractor for Delivering Fetal head duringLSCS: A Preliminary study.
Journal Title: IOSR Journal of Dental and Medical Sciences (IOSR-JDMS) - Year 2018, Vol 17, Issue 1
Abstract
Background: To deliver the head while doing lower segment caesarean section, the current conventional practice is to insert fingers through the uterine wound between the head and the lower uterine segment till fingers reach below the head, and then the head is levered out.This procedure,sometimes results in irregular extension of angles of the wound,which may involvethe uterine vessels,resulting in heavy bleeding. Irregular tearing of the uterine wound also leads fordifficult suturing.To avoid this, we tried a specially developed instrument called cephalic extractor to deliver the head with success. Methods: This instrument looks similar to that of a single blade of outlet forceps.Eighteen women with cephalic presentation, and two women with breech presentation, who underwent LSCS were included in this study. Caesarean sections done for fetal distress were excluded.Eleven of these women underwent trial of labor, and in 9 women no trial was given. We used two differentmethods, ‘Direct’ and ‘Indirect’ methodsfor its application. After opening the uterus by lower segment transverse incision, the instrument was applied and the head or breech was delivered by gentle traction. In case of deeply engaged head, the head was dislodged from pelvis by an assistant pushing it up from vagina, and then the instrument was applied. Lateral extension of the uterine incision wound, soft tissue injuries to mothers and neonates, APGAR scores at 1min and at 5min, and the time taken for the delivery of the baby were recorded in all women. Results: No irregular tearing of the uterine wound and no soft tissue injuries to mothers or babies were observed. The APGAR scores of all neonates at one min were 9. The time taken for delivery was less than 1min in all women. In 2 women with deep transverse arrest, there was minimal lateral extension of wound. Conclusion: Application of S.R Cephalic Extractor for delivering the head or breach at lower segment caesarean section is safe,helps for quick delivery of the baby, and avoids irregular tearing of the angles of the wound,which minimizes blood loss andhelps for easy closure.
Authors and Affiliations
Dr. Samrtha Ram Hemmanur, Illa Sai Samyuktha, H S. Shankar Ram
Keywords
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