El Saman, A., Abbas, A., Ali, M., Othman, E., Mohamed, I., Khalaf, M., Bahloul, M., El Saman, D. (2017). External Pop-out Cesarean Section: A Novel Technique for Supporting the Lower Uterine Segment During Fetal Head Extraction. test, 7(1), 36-41. doi: 10.21608/ebwhj.2017.3223
Ali El Saman; Ahmed Abbas; Mohammed Ali; Essam Othman; Ibrahim Mohamed; Mohamed Khalaf; Mustafa Bahloul; Dina El Saman. "External Pop-out Cesarean Section: A Novel Technique for Supporting the Lower Uterine Segment During Fetal Head Extraction". test, 7, 1, 2017, 36-41. doi: 10.21608/ebwhj.2017.3223
El Saman, A., Abbas, A., Ali, M., Othman, E., Mohamed, I., Khalaf, M., Bahloul, M., El Saman, D. (2017). 'External Pop-out Cesarean Section: A Novel Technique for Supporting the Lower Uterine Segment During Fetal Head Extraction', test, 7(1), pp. 36-41. doi: 10.21608/ebwhj.2017.3223
El Saman, A., Abbas, A., Ali, M., Othman, E., Mohamed, I., Khalaf, M., Bahloul, M., El Saman, D. External Pop-out Cesarean Section: A Novel Technique for Supporting the Lower Uterine Segment During Fetal Head Extraction. test, 2017; 7(1): 36-41. doi: 10.21608/ebwhj.2017.3223

External Pop-out Cesarean Section: A Novel Technique for Supporting the Lower Uterine Segment During Fetal Head Extraction

Evidence Based Women's Health Journal
Article 6, Volume 7, Issue 1, February 2017, Pages 36-41    PDF (1.92 M)
Document Type: Original Article
DOI: 10.21608/ebwhj.2017.3223
Authors
Ali El Saman* 1; Ahmed Abbas2; Mohammed Ali1; Essam Othman2; Ibrahim Mohamed2; Mohamed Khalaf2; Mustafa Bahloul2; Dina El Saman3
1Department of Obstetrics and Gynecology, Woman's Health Hospital, Assiut University, Assiut, Egypt
2Department of Obstetrics and Gynecology, Woman's Health Hospital, Assiut University, Assiut, Egypt.
3Faculty of Medicine, Assiut University, Assiut, Egypt
Abstract
Objectives: To assess the safety and feasibility of a novel technique, External Pop-out (EPO), for supporting the lower
uterine segment during fetal head extraction in cesarean section (CS).
Study design: Prospective cohort study.
Patients and Methods: The current research is a registered (NCT02755168) study compassing the new technique, EPO,
for head extraction during CS. The technique was performed on single, living, cephalic, elective cesarean deliveries at
Women's Health Hospital, Assiut University, Egypt. The primary study outcomes were; the feasibility and the rate of
incision extensions with the External Pop-out technique. The secondary outcomes included the easiness score and the
learning curve of this technique on five senior obstetricians’ trainee.
Results: The EPO technique was successful in 845/877 cases (96.3%) but impossible in the remaining 32 case because of
extensive pelvic adhesions. The rate of occurrence of minor extensions associated with EPO was 8/845 (0.95%) with no
major extensions in succeeded cases. There was a statistically significant difference between the mean of easiness score in the early 5 cases and the next 5 cases in 4 out of 5 trainees. The remaining trainee reported a higher easiness score earlier from his 4th case. The mean of total scores in the late cases was also significantly higher than the early cases (p=0.0001).
Conclusions: External Pop-out technique is feasible with low rates of uterine incisions extensions. Moreover; this
technique is easily learned and performed by obstetricians
Keywords
cesarean section; Fetal Head Extraction; maternal morbidity; Uterine Extension
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