The Fetal Pillow
The Fetal Pillow (Safe Obstetric Systems, New York, New York) is a single-use fetal cephalic elevation device for managing the deeply impacted fetal head (FIGURE 3). The Fetal Pillow has a firm plastic base upon which is attached a soft silicon balloon. The Fetal Pillow is inserted into the vagina prior to initiating CD and the balloon is filled with 180 mL of saline, causing the fetal head to be pushed to a higher station (FIGURE 4). Use of the Fetal Pillow may be indicated prior to CD in the following situations:
- second stage labor with a deeply impacted head
- second stage labor and failed operative delivery
- occiput posterior position or deep transverse arrest
- absent progress in the first stage between 8 cm and 10 cm with a deeply impacted fetal head or excessive caput of the fetal head.
The Fetal Pillow is inserted after completing vaginal preparation for CD and before initiating skin preparation and abdominal draping. The steps for inserting the Fetal Pillow include:
- Use the 60 mL syringe to fully deflate the Fetal Pillow and leave the cock-stop open.
- Fold the Fetal Pillow by squeezing the firm plastic base, and with the patient’s legs in a frog-leg position, place the device in the vagina.
- Allow the firm plastic base to open to a flat position with the base against the posterior vaginal wall and the soft silicon balloon against the fetal head.
- Using pressure on the plastic base, gently push the Fetal Pillow posteriorly toward the sacrum of the mother.
- Use the 60 mL syringe to inflate the balloon with 180 mL of normal saline and close the valve.
- Straighten the patient’s legs and proceed with skin preparation and abdominal draping (FIGURE 4).
When the CD is completed, deflate the balloon by drawing out the saline with the 60 mL syringe and remove the device by hooking a finger around the firm plastic base. The Fetal Pillow is surprisingly easy to use.
Continue to: Effectiveness of the Fetal Pillow...