1. Fetal Pillow at full dilatation
Michael Beckmann
Huda Safa

2. Background Deeply engaged fetal head RANZCOG guideline Fetal Pillow
1-2% of CS
Associated with adverse maternal and neonatal outcomes
RANZCOG guideline
Fetal Pillow
Mater Health Services first unit in Australia
2 fetal deaths subject to Coronial Investigation

3. Objective
Report the initial Australian experience with use of the Fetal Pillow

4. Methods Retrospective cohort study
Women who underwent CS at full dilatation
Between May March 2015
Mater Mothers Hospitals, South Brisbane
Data extracted from electronic maternity record
Comparison
Cases where the FP method was used
Cases where the hand–push method was used
Maternal and neonatal outcomes reported

5. Results 361 CS performed at full dilation FP-method 91 cases
Hand-push method 69 cases
Similar baseline characteristics
Fetal Pillow
Hand-push
P-value
Nullipara
82%
66%
0.15
Age
30y
31y
0.39
BMI 25 24
0.61
Gestation 40
0.54
Category 1 CS
49%
52%
0.95
Failed instrument 6% 4%

6. Results Women in whom the FP-method was used
Shorter post-partum length-of stay
Higher cord arterial pH
Less EBL
Other outcomes similar
Fetal Pillow
Hand-push
P-value
Apgar 5 minutes 3% 6%
0.44
Intubated 0%
0.10
Nursery admission
15%
25%
0.14
Cord arterial pH
7.24
7.19
0.02*
Mean EBL
273ml
403ml
0.03*
Blood transfusion
0.71
Angle extension
20%
34%
0.09
Post-partum LOS
78h
98h
0.01*

7. Conclusions Initial findings Clinician feedback universally positive
confirm others experience
effective aid when deeply impacted fetal head
larger numbers are needed
Clinician feedback universally positive
Risk minimisation