Comparative study of vectis versus manual method for extraction of fetal head during lower segment cesarean section

Abstract

Background: Delivery of fetal head through uterine incision is often the major technical problem during low transverse cesarean section when the presenting part is unengaged. Techniques to deliver head under special circumstances are traumatic to both mother and fetus. This study aims to establish the role of vectis in extraction of fetal head during lower segment cesarean section (LSCS) and to assess associated difficulties or untoward effects of use of vectis over manual method.Methods: The study was undertaken in PESIMSR, Kuppam, Andhra Pradesh over two years. Vectis was used in extraction of fetal head in LSCS in 100 cases of full term pregnancy and maternal and neonatal outcomes were compared with 100 cases of manual extraction.Results: Incision-delivery time interval was similar in both vectis and manual extraction method (p value of 0.390). Vectis group did not require any fundal pressure for extraction of head where as 100% of women in manual extraction group required fundal pressure (p value: <0.001) which is statistically significant. The length of abdominal incision for majority of cases in vectis group was smaller and statistically significant compared to manual extraction group (p value of 0.001). Neonatal outcomes were similar in both the groups.Conclusions: As per our study, usage of vectis has shown significant advantage in reducing maternal discomfort caused due to fundal pressure and length of abdominal incision required, with negligible difference in neonatal and other maternal outcomes in comparison to manual method of extraction.