Fetal Pillow

Fetal Pillow is a balloon device made by Safe Obstetric Systems that is used in obstetrics. It is used to elevate the fetal head when it is deep in the pelvic cavity before performing a caesarean section. This often occurs when the caesarean section is carried out late in labour at full dilation of the cervix.[1][2][3]

The device was invented by Dr Rajiv Varma, a consultant obstetrician and gynaecological surgeon based in England. The device was first described in 2007,[4] where it was reported to make the delivery of the head easier and reduced the risk of complications for the mother and baby that occur when a caesarean section is carried out at full dilation.[5][6] These included reduced risk of bleeding during the caesarean section and also prevented injuries to the baby that are caused when the delivery of baby is difficult due to its deep position in the pelvic cavity.[7]

The device is a silicone balloon that inflates only in one direction, it is inserted below the baby’s head and inflated using saline fluid with a syringe. This forms a bubble of fluid under the baby’s head and elevates it, making the delivery by the surgeon less traumatic to the mother and baby.[8][9]

The literature highlights significant reduction in maternal complications including uterine extensions, blood loss and blood transfusions. Also highlighted are significant reduction in operating time and length of stay.[10]

## References

1. ↑ Blickstein I. Difficult delivery of the impacted fetal head during cesarean section: intraoperative disengagement dystocia. Journal of Perinatal Medicine. 2004. 32:465–469.
2. ↑ Murphy DJ, Liebling RE, Verity L, Swingler R, Patel R. Early maternal and neonatal morbidity associated with operative delivery in second stage of labour: a cohort study. Lancet 2001;358:1203–7.
3. ↑ Unterscheider J, McMenamin M, Cullinane F. Rising rates of cesarean deliveries at full cervical dilation: a concerning trend. Eur J Obstet Gynecol Reprod Biol. 2011 Aug;157(2):141-4. doi: 10.1016/j.ejogrb.2011.03.008. Epub 2011 Apr 5.
4. ↑ Sung JF, Daniels KI, Brodzinsky L, El-Sayed Y. Cesarean delivery outcomes after a prolonged second stage of labour. Am J Obstet Gynecol. 2007; 197: 306 e1-306 e5.
5. ↑ Singh M, Varma R. Reducing complications associated with a deeply engaged head at caesarean section: a simple instrument. The Obstetrician & Gynaecologist 2008;10:38–41. doi:10.1576/toag.10.1.038.27376
6. ↑ N. Papanikolaou, A. Tillisi, L. Louay, M. Singh, A. Ikomi, R. Varma. Reducing complications related to Caesarean section (CS) in second stage: UK experience in the use of fetal disimpacting system (FDS) International Journal of Gynecology & Obstetrics 107S2 (2009) S93–S396
7. ↑ Seal SL, Dey A, Barman SC, Kamilya G, Mukherji J. Does elevating the fetal head prior to delivery using a fetal pillow reduce maternal and fetal complications in a full dilatation caesarean section? A prospective study with historical controls. Journal of Obstetrics and Gynaecology. 2014 Apr 1;34(3):241-4.
8. ↑ P Angala, M Raja, M Ikomi, R Varma. A Simple Classification System for Maternal Traumatic Injuries Associated with Second Stage Caesarean Section. Arch Dis Child Fetal Neonatal Ed 2013;98:A63 doi:10.1136/archdischild-2013-303966.214
9. ↑ Seal SL, Dey A, Barman SC, Kamilya G, Mukherji J. Does elevating the fetal head prior to delivery using a fetal pillow reduce maternal and fetal complications in a full dilatation caesarean section? A prospective study with historical controls. Journal of Obstetrics and Gynaecology. 2014 Apr 1;34(3):241-4.
10. ↑ Seal, Subrata L.; Dey, Alok; Barman, Sannyashi C.; Kamilya, Gourisankar; Mukherji, Joydev; Onwude, Joseph L. (2016-05-01). "Randomized controlled trial of elevation of the fetal head with a fetal pillow during cesarean delivery at full cervical dilatation" (in en). International Journal of Gynecology & Obstetrics 133 (2): 178–182. doi:10.1016/j.ijgo.2015.09.019. ISSN 1879-3479. PMID 26868074.

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