Symphysiotomy for feto-pelvic disproportion

Symphysiotomy: Is it obsolete?

“…It was 6% in another series of 100 CS in rural Tanzania. We could not find any published reports of maternal mortality directly related to symphysiotomy in the antibiotic era to date 2 . Both ventouse and forceps can be applied after SYM to achieve a vaginal delivery if spontaneous delivery does not occur.…”

“…In July 2003, maternal health specialists from around the world gathered in Bellagio, Italy, to develop a list of proven and promising technologies appropriate for low‐resource settings to reduce maternal mortality 9 . Symphysiotomy is advocated as one such simple underused and alternative technology that can save the lives of women with obstructed labor and its sequelae, such as uterine rupture, sepsis, and neonatal mortality and morbidity, even if the women live far from a health centre 2,10,11 …”

“…Therefore, the non‐availability of specialized doctors in rural areas of our country can be bypassed by training every midwife or graduate doctor how to perform this simple procedure, thus saving the lives of many poor mothers. Moreover, it is a quick procedure, requiring few instruments 2 . Its main advantage is that it does not carry the risk of scarred uterus in subsequent pregnancies, particularly when the woman may not have ready access to CS in the future.…”

Symphysiotomy: Is it obsolete?

“…It was 6% in another series of 100 CS in rural Tanzania. We could not find any published reports of maternal mortality directly related to symphysiotomy in the antibiotic era to date 2 . Both ventouse and forceps can be applied after SYM to achieve a vaginal delivery if spontaneous delivery does not occur.…”

“…In July 2003, maternal health specialists from around the world gathered in Bellagio, Italy, to develop a list of proven and promising technologies appropriate for low‐resource settings to reduce maternal mortality 9 . Symphysiotomy is advocated as one such simple underused and alternative technology that can save the lives of women with obstructed labor and its sequelae, such as uterine rupture, sepsis, and neonatal mortality and morbidity, even if the women live far from a health centre 2,10,11 …”

“…Therefore, the non‐availability of specialized doctors in rural areas of our country can be bypassed by training every midwife or graduate doctor how to perform this simple procedure, thus saving the lives of many poor mothers. Moreover, it is a quick procedure, requiring few instruments 2 . Its main advantage is that it does not carry the risk of scarred uterus in subsequent pregnancies, particularly when the woman may not have ready access to CS in the future.…”

Symphysiotomy for obstructed labour: a systematic review and meta‐analysis

“…Caesarean section is one the commonest surgical procedures performed worldwide and has good data on the benefits and risks . Caesarean section is generally associated with a low complication rate yet like many surgical procedures this can fluctuate with the skill of the operator, the reason for the procedure, the clinical environment and any co‐morbidities, and so the complication rate may differ significantly between high‐income and low‐income countries. A comparable body of evidence is not available for the risks and benefits associated with symphysiotomy, because it is a much less common procedure.…”

“…In the absence of randomised data, a Cochrane review concluded that research was needed to provide robust evidence on the effectiveness and safety of symphysiotomy compared with caesarean section in clinical situations in which the risks and benefits are uncertain. One systematic review of retrospective case series concluded that with training, symphysiotomy poses no greater risks and compares favourably with caesarean section, in terms of risk for the mother's life.…”

Symphysiotomy: Is it obsolete?

“…It was 6% in another series of 100 CS in rural Tanzania. We could not find any published reports of maternal mortality directly related to symphysiotomy in the antibiotic era to date 2 . Both ventouse and forceps can be applied after SYM to achieve a vaginal delivery if spontaneous delivery does not occur.…”

“…In July 2003, maternal health specialists from around the world gathered in Bellagio, Italy, to develop a list of proven and promising technologies appropriate for low‐resource settings to reduce maternal mortality 9 . Symphysiotomy is advocated as one such simple underused and alternative technology that can save the lives of women with obstructed labor and its sequelae, such as uterine rupture, sepsis, and neonatal mortality and morbidity, even if the women live far from a health centre 2,10,11 …”

“…Therefore, the non‐availability of specialized doctors in rural areas of our country can be bypassed by training every midwife or graduate doctor how to perform this simple procedure, thus saving the lives of many poor mothers. Moreover, it is a quick procedure, requiring few instruments 2 . Its main advantage is that it does not carry the risk of scarred uterus in subsequent pregnancies, particularly when the woman may not have ready access to CS in the future.…”

Symphysiotomy for obstructed labour: a systematic review and meta‐analysis

“…Caesarean section is one the commonest surgical procedures performed worldwide and has good data on the benefits and risks . Caesarean section is generally associated with a low complication rate yet like many surgical procedures this can fluctuate with the skill of the operator, the reason for the procedure, the clinical environment and any co‐morbidities, and so the complication rate may differ significantly between high‐income and low‐income countries. A comparable body of evidence is not available for the risks and benefits associated with symphysiotomy, because it is a much less common procedure.…”

“…In the absence of randomised data, a Cochrane review concluded that research was needed to provide robust evidence on the effectiveness and safety of symphysiotomy compared with caesarean section in clinical situations in which the risks and benefits are uncertain. One systematic review of retrospective case series concluded that with training, symphysiotomy poses no greater risks and compares favourably with caesarean section, in terms of risk for the mother's life.…”

Symphysiotomy: Is it obsolete?

“…It was 6% in another series of 100 CS in rural Tanzania. We could not find any published reports of maternal mortality directly related to symphysiotomy in the antibiotic era to date 2 . Both ventouse and forceps can be applied after SYM to achieve a vaginal delivery if spontaneous delivery does not occur.…”

“…In July 2003, maternal health specialists from around the world gathered in Bellagio, Italy, to develop a list of proven and promising technologies appropriate for low‐resource settings to reduce maternal mortality 9 . Symphysiotomy is advocated as one such simple underused and alternative technology that can save the lives of women with obstructed labor and its sequelae, such as uterine rupture, sepsis, and neonatal mortality and morbidity, even if the women live far from a health centre 2,10,11 …”

“…Therefore, the non‐availability of specialized doctors in rural areas of our country can be bypassed by training every midwife or graduate doctor how to perform this simple procedure, thus saving the lives of many poor mothers. Moreover, it is a quick procedure, requiring few instruments 2 . Its main advantage is that it does not carry the risk of scarred uterus in subsequent pregnancies, particularly when the woman may not have ready access to CS in the future.…”

Symphysiotomy for obstructed labour: a systematic review and meta‐analysis

“…Caesarean section is one the commonest surgical procedures performed worldwide and has good data on the benefits and risks . Caesarean section is generally associated with a low complication rate yet like many surgical procedures this can fluctuate with the skill of the operator, the reason for the procedure, the clinical environment and any co‐morbidities, and so the complication rate may differ significantly between high‐income and low‐income countries. A comparable body of evidence is not available for the risks and benefits associated with symphysiotomy, because it is a much less common procedure.…”

“…In the absence of randomised data, a Cochrane review concluded that research was needed to provide robust evidence on the effectiveness and safety of symphysiotomy compared with caesarean section in clinical situations in which the risks and benefits are uncertain. One systematic review of retrospective case series concluded that with training, symphysiotomy poses no greater risks and compares favourably with caesarean section, in terms of risk for the mother's life.…”