New evidence by NICE indicates that fetal balloon procedure during an emergency c-section to safely deliver the baby.
The National Institute of Health and Care Excellence (NICE) interventional procedures advisory committee showed the procedure was safe and effective to be used by maternity staff trained in managing impacted babies’ heads during an emergency c-section. The aim of the procedure is to elevate the baby’s head away from the mother’s pelvis without trauma.
A category 1 emergency c-section are typically performed where there is a concern for the baby, such as distress. However, other reasons may include the mother becoming unwell or heavy bleeding. Whereas a category 2 emergency c-section is commonly implemented where labour has slowed or stopped and interventions to encourage birth have been unsuccessful.
What is the fetal balloon procedure?
The fetal balloon procedure uses a disposable soft silicone balloon device inserted into the vagina, using a lubricant. It is pushed towards the coccyx and placed between the pelvic floor and the baby’s head.
The balloon surface is placed in contact with the head whilst the base plate of the device rests on the anococcygeal ligament to prevent downward displacement when the device is inflated. Once it is in position, it is inflated using sterile saline through a tube. The balloon is specifically designed to inflate in an upwards direction and it works by pushing the engaged head out of the pelvis by a few centimetres.
It aims to make birth easier during an emergency c-section, with reduced manipulation through the abdominal wound, and to reduce the risk of injury to both the mother and baby.
Following birth, the balloon will be deflated and the device will be removed. Dr Gail Allsopp, interim chief medical officer at NICE, said: “Having an emergency caesarean because your baby’s head has become stuck in the pelvis will be a traumatic time for a mother.
“Using a fetal balloon is an option for the delivery team, if trained, to help during an emergency caesarean section, aiming to deliver the baby safely.
“This evidence-based recommendation will help to drive an innovative product into the hands of health and care professionals to enable best practice.”
Supporting mothers through emergency c-section
In this UK study, 159 (82%) of the 194 hospitals with obstetric units in the UK, reported 3,518 second stage emergency c-sections. There are 557 reports of the use of a dis-impaction technique or of “difficulty” delivering the head in the final analysis.
The pillow was used 142 times in emergency c-sections as a preventative measure (25%) and 34 times as treatment, in all cases the pillow was placed and inflated.
The committee found no major safety concerns with this procedure.