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Cephalic Elevation Device for Second-Stage Cesarean Delivery: A Randomized Controlled Trial.

Sarah C Lassey1, Sarah E Little, Michael Saadeh

  • 1Department of Obstetrics and Gynecology, Division of Maternal-Fetal Medicine, Brigham and Women's Hospital, Boston, Massachusetts.

Obstetrics and Gynecology
|March 14, 2020
PubMed
Summary
This summary is machine-generated.

A cephalic elevation device significantly reduced delivery time during second-stage cesarean births. This inflatable device, used to elevate the fetal head, shortened the time from hysterotomy to delivery by 23 seconds without impacting neonatal outcomes.

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Area of Science:

  • Obstetrics and Gynecology
  • Surgical Innovation
  • Maternal-Fetal Medicine

Background:

  • Cesarean deliveries during the second stage of labor can be prolonged.
  • Elevating the fetal head may facilitate delivery.
  • A novel inflatable cephalic elevation device aims to improve surgical efficiency.

Purpose of the Study:

  • To evaluate the efficacy of a cephalic elevation device in reducing time to delivery after hysterotomy.
  • To assess the impact of the device on neonatal morbidity in second-stage cesarean deliveries.

Main Methods:

  • A double-blind randomized controlled trial was conducted with 60 nulliparous women undergoing second-stage cesarean delivery.
  • Participants were randomized to either inflation or non-inflation of the cephalic elevation device.
  • The primary outcome measured was the time from hysterotomy to delivery.

Main Results:

  • The median time from hysterotomy to delivery was significantly shorter in the device inflation group (31 seconds) compared to the non-inflation group (54 seconds) (P<.01).
  • The use of the cephalic elevation device resulted in a 23-second reduction in delivery time.
  • No significant differences in neonatal outcomes were observed between the groups.

Conclusions:

  • The cephalic elevation device is effective in reducing the time to delivery during second-stage cesarean births.
  • This device offers a potential method to improve efficiency in specific cesarean delivery scenarios.
  • Further research may explore broader applications and long-term maternal outcomes.