Cephalic Elevation Device for Second-Stage Cesarean Delivery
| Autor: | Michael Saadeh, Sarah E Little, Nicole Patton, Julian N. Robinson, Michaela K. Farber, Brian T. Bateman, Sarah C. Lassey |
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| Rok vydání: | 2020 |
| Předmět: |
Adult
medicine.medical_specialty Adolescent medicine.medical_treatment Prenatal care law.invention Young Adult 03 medical and health sciences 0302 clinical medicine Double-Blind Method Randomized controlled trial Labor Stage Second Pregnancy law medicine Humans Fetal head 030212 general & internal medicine Hysterotomy Young adult reproductive and urinary physiology Original Research 030219 obstetrics & reproductive medicine Intention-to-treat analysis Cesarean Section business.industry Obstetrics Pregnancy Outcome Obstetrics and Gynecology Prenatal Care Middle Aged medicine.disease Clinical trial Treatment Outcome Female Contents business |
| Zdroj: | Obstetrics and Gynecology |
| ISSN: | 0029-7844 |
| DOI: | 10.1097/aog.0000000000003746 |
| Popis: | Using a cephalic elevation device during second-stage cesarean deliveries decreases time to delivery after hysterotomy by 23 seconds. OBJECTIVE: A cephalic elevation device is an inflatable device that elevates the fetal head. We sought to evaluate whether such a device reduces time to delivery after hysterotomy and lowers morbidity in cesarean deliveries during the second stage of labor. METHODS: We conducted a double-blind randomized controlled trial among nulliparous, term women aged 18–50 years with vertex singleton pregnancies. Women were eligible if they were to undergo cesarean delivery in the second stage of labor. All participating women had the cephalic elevation device inserted by the delivering provider and were randomly allocated to inflation or noninflation of the device. Inflation was performed in a blinded fashion. The primary outcome was time from hysterotomy to delivery. A sample size of 30 per group (N=60 participants) was planned to detect a 50% decrease in time to delivery after hysterotomy with cephalic elevation device inflation. RESULTS: From January 2018 through July 2019, 60 women who underwent cesarean delivery in the second stage were randomized. Analysis was by intention to treat. Women in the inflation group were older (33 vs 30.5 years), but the groups were otherwise similar. In both groups, most women had a low-transverse hysterotomy (93%). The median time from hysterotomy to delivery was significantly shorter in the inflation group (31 vs 54 seconds; P |
| Databáze: | OpenAIRE |
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