VACUUM-ASSISTED CESAREAN SECTION – A NOVEL STUDY

Dr. Deepali Janugade, Dr. Rajkumar Patange

Abstract


Objective : The rate of cesarean deliveries has increased over a decade due to multifactorial reasons explicitly; decrease in vaginal births after cesarean (VBAC), multiple gestation, maternal obesity, pre-term labor, gestational diabetes or hypertension, increased number of high-risk expectant mothers and the obstetrical medico-legal environment. This upsurge, coupled with a decreasing willingness to allow vaginal birth after cesarean section, has resulted in an expansion of the use of vacuum assistance to safely extract the fetal head. By avoiding the use of a delivering hand or forceps blade, the volume being delivered through the uterine incision can be decreased when the vacuum is used properly. Reducing uterine extensions with their associated complications (eg, excessive blood loss) in difficult cases is also a theoretical advantage of vacuum delivery.

Materials and methods : This study was conducted on 50 full term pregnant women undergoing cesarean section at Krishna Institute of Medical Sciences, Karad, Maharashtra, India. All patients were between 37 and 41 weeks of pregnancy with signs of healthy fetus and were divided into 2 groups; Group A- 25 patients subjected to vacuum extraction at the cesarean section, Group B- 25 patients subjected to the conventional cesarean method. Fetal head delivery technique (Manual/Vacuum), U-D interval (by stopwatch), blood loss for the procedure (by suctioning) was estimated. Presence of any complication like extension of uterine incision, cervical laceration, PPH were noted.

Results : Application of fundal pressure was required in all cases of manual 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, 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, and in the vacuum extraction group it was 454±66.92 ml.

Conclusion : It was found that the use of vacuum extractor is an easy, non traumatic and rapid method which abates the need of rough and prolonged fundal compression and its consequences and significantly fewer maternal complications.


Keywords


Vacuum extraction, cesarean section

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References


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