Management of impacted fetal head at caesarean section - Current practice and future development
Laura van der Krogt1, Natalie Suff1, Lisa Story1
1Division of Women's Health King's College London Women's Health Academic Centre St Thomas' Hospital United Kingdom.
Worldwide, more than 1 in 5 women give birth by cesarean delivery, and at least 5% of these births are at full dilatation. In labour and at full dilatation, a caesarean section can be technically challenging and is associated with greater risks. The fetal head is lower and can be wedged within the maternal pelvis making it more difficult to deliver, a situation known as 'impacted fetal head'. This is associated with increased maternal and neonatal morbidity including uterine extensions, haemorrhage, fetal trauma and hypoxic ischaemic encephalopathy. This review explores the scope of the issue including the evidence for prevention and management of impacted fetal head, while highlighting key areas for future research.
Worldwide, more than 1 in 5 women give birth by cesarean delivery, and at least 5% of these births are at full dilatation. In labour and at full dilatation, a caesarean section can be technically challenging and is associated with greater risks. The fetal head is lower and can be wedged within the maternal pelvis making it more difficult to deliver, a situation known as 'impacted fetal head'. This is associated with increased maternal and neonatal morbidity including uterine extensions, haemorrhage, fetal trauma and hypoxic ischaemic encephalopathy. This review explores the scope of the issue including the evidence for prevention and management of impacted fetal head, while highlighting key areas for future research.
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