Study between modified Patwardhan technique and Foetal Pillow during Caesarean section in full dilatation in cases of deeply engaged foetal head

'A Comparative study between modified Patwardhan technique and Foetal Pillow during Caesarean section in full dilatation in cases of deeply engaged foetal head.' Seal et al, 2019.

To view full study: http://www.iosrjournals.org/iosr-jdms/papers/Vol18-issue9/Series-4/A1809040107.pdf

Objective: To evaluate whether use of the Foetal Pillow (Safe Obstetric Systems, Shenfield, UK) reduces maternal and foetal morbidity in cesarean delivery at full cervical dilatation as compared to Modified Patwardhan technique.

Methods: A comparative prospective study was conducted in a tertiary teaching hospital, West Bengal between May 2016 to April 2017. A total of fifty women undergoing caesarean delivery at full dilatation (CSFD) were randomised into two groups i.e. Foetal Pillow (FP) and Modified Patwardhan (MP) group. Outcomes such as extension of uterine incision, operating time, uterine incision to delivery time and blood loss were measured.

Results: In FP group, only two (8%) had extension of uterine incision as compared to six patients (24%) in MP group, which was statistically significant (p 0.001). Operating time and incision-to-delivery interval was significantly shorter in FP group than MP group (p 0.02 & p 0.04 respectively). Blood loss was also significantly more in FP group than MP group (p 0.02).

Conclusion: The comparative study revealed that patients studied with Foetal pillow had far better outcome in terms of maternal and fetal morbidity compared to the patients studied with Modified Patwardhan technique.

  • A lower incidence of extension of uterine incision.
  • Increased volume of blood loss, requirement of blood transfusion.
  • The operating time (skin to skin) in mins and uterine incision to delivery time in mins were also lesser in Foetal Pillow group.
  • Requirement of SNCU admission and incidence of neonatal seizure were also comparatively less in Foetal Pillow group.
  • ​Early Neonatal death after use of Patwardhan Technique.
Written by:

Dr Rajiv Varma MB, FRCOG

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