(842) The use of a Fetal Pillow device at full dilation cesarean delivery

Impacted fetal head at full dilation cesarean delivery (CD) is a major cause of adverse maternal and neonatal outcomes. The Fetal Pillow is a device designed to reduce these complications. Our study aims to evaluate the outcomes of full-dilation CD with and without the use of Fetal Pillow.


Study Design:

This retrospective cohort study included full-dilation CDs performed from January 2018 to July 2023, at a single tertiary center.  Indications for CDs were arrest of decent, fetal distress and failed vacuum extraction. The study cohort included cases (Fetal Pillow group) matched to controls (without the use of Fetal Pillow) according to the indication to CD, in a 1: 2 ratio. The study evaluated maternal outcomes such as uterine incision extensions, maternal blood loss (ml), maternal postoperative infection and postoperative length of stay (days). Neonatal outcomes included NICU admissions, cord arterial blood pH, Apgar scores, respiratory distress, birth trauma, and encephalopathy.


Results:

The study cohort included a total of 138 patients who underwent CD at full dilation. Among them, 46 were in the Fetal Pillow group, and 92 were controls. There were no significant differences between the groups in maternal characteristics such as age, BMI, previous CDs and obstetrics complications. There were also no differences between the groups in the rate of uterine extensions, maternal blood loss, postoperative infection or postoperative length of stay . The fetal pillow group had a lower rate of neonatal NICU admissions compared to the controls (17.3% versus 33.7%, respectively, p=0.04). There were no differences between the groups in any other fetal outcomes. 


Conclusion:

The use of Fetal Pillow for impacted fetal head during full dilation CDs was not associated with any maternal complications. The use of Fetal Pillow may reduce NICU admissions.