Publication:

Assisted delivery of mobile fetal head: a comparison of forceps, vaccum and assisted manual extraction of head at caesarean section

Background Difficult fetal extraction occurs in 1-2% of caesarean deliveries. Either forceps or a vaccum device is often used to assist in delivery of the fetal head in cesarean section in high floating/mobile fetal head.  This study compare the safety (for mother and fetus) and efficacy of forceps and vacuum assisted delivery of high floating/mobile fetal head with the traditional method of manual extraction at caesarean section.

Methods The sample size included 100 cases of LSCS with manual extraction of fetal head, 100 cases of LSCS with forceps assisted extraction of fetal head and 100 cases of LSCS with vacuum assisted extraction of fetal head.

Results Application of fundal pressure was required in all cases of manual extraction group, in 51 cases of forceps extraction group. None of the cases of vacuum extraction group required application of fundal pressure. The U-D interval in manual extraction group was 90.56±4.91 seconds, in forceps extraction group was 70.2±5.02 seconds and in the vacuum extraction group it was 62.3±2.03 seconds. In the manual extraction group, there was an estimated blood loss of 428±69.38 ml, 579±97.22 ml of estimated blood loss was present in forceps extraction group and in the vacuum extraction group it was 454±66.92 ml.

Conclusions This study reveals that with use of vacuum in CS for delivery of floating head, is superior than application of forceps and manual delivery in relation to time, blood loss and fundal pressure without any adverse effect on neonates and maternal complication.