Effectiveness of the fetal pillow to prevent adverse maternal and fetal outcomes at full dilatation cesarean section in routine practice.
INTRODUCTION
The fetal pillow has been suggested to reduce maternal trauma and fetal adverse outcomes when used to disimpact the fetal head at full dilatation cesarean section.


MATERIAL AND METHODS
We performed a retrospective cohort study of the use of the fetal pillow device at full dilatation cesarean section between September 2014 and March 2018 at Liverpool Women's Hospital, a large UK teaching hospital.


RESULTS
There were 471 cases of full dilatation cesarean section during the study period and 391 were included for the analysis; 170 used the fetal pillow and 221 were delivered without. We did not demonstrate any benefit in the significant maternal outcomes of estimated blood loss >1000 mL or >1500 mL, need for blood transfusion, or duration of hospital stay, from the use of the fetal pillow. We did not demonstrate any improvement in fetal outcome following use of the fetal pillow for arterial pH <7.1, Apgar score <7 at 5 minutes or admission to the neonatal unit. For deliveries undertaken at or below the level of the ischial spines there was likewise no benefit from fetal pillow use, except in a reduced risk of an arterial pH <7.1 (relative risk 0.39, 95% CI 0.20-0.80, P = .01); however, admission to the neonatal unit was unaffected.


CONCLUSIONS
This is the largest study to date on the use of the fetal pillow at full dilatation cesarean section. We did not demonstrate any statistically significant benefit from the use of the fetal pillow to prevent any maternal or fetal adverse outcomes at full dilatation cesarean section in routine clinical use. Further randomized studies are required to prove clinical benefit from this device before more widespread use.
['Sacre|Helen|H|', 'Bird|Alice|A|', 'Clement-Jones|Mark|M|', 'Sharp|Andrew|A|0000-0003-3396-7464']
D000328:Adult D001720:Birth Injuries D002585:Cesarean Section D015331:Cohort Studies D005260:Female D006801:Humans D007747:Labor Stage, First D007748:Labor Stage, Second D011247:Pregnancy D012189:Retrospective Studies D006113:United Kingdom
fetal pillow cesarean section fetal adverse outcomes fetal head obstetrics