Низько розташована голівка плода під час кесаревого розтину: поширеність, фактори ризику, методи профілактики та менеджмент (огляд літератури)

Abstract

Under certain circumstances, the fetal head may stop descending into the vagina during the second stage of labor, having its largest circumference into the pelvic cavity, while conservative methods of treatment may not be effective, and the clinical situation may require an emergency cesarean section with a "the deeply impacted fetal head" in the pelvic cavity. This is a technically complex method of delivery in this clinical situation, associated with serious risks for both the woman and the child. There are a number of approaches to prevent these complications and techniques for removing the fetus in this situation, however, there is currently no consensus on which of these approaches is best for this type of cesarean section. The aim - to investigate the main current data on possible techniques for fetal extraction with impacted fetal head during cesarean section and to compare their safety and effectiveness. A review of the literature on the definition of the concept of «impacted fetal head» during cesarean section, the distribution and risk factors of this complication, the study of possible complications for the mother and the fetus, techniques for preventing the occurrence of this condition, methods of removing the fetus with impacted head during cesarean section, as well as promising management methods. A comprehensive study of this obstetric emergency remains relevant for modern science, because it requires special techniques and skills of an obstetrician-gynecologist to prevent injuries to the mother and child, bleeding and other life-threatening conditions. There is a need to standardize the definition of terminology, improve the skills of doctors through simulation training and conduct large randomised trials to determine the best approaches and provide highly skilled care to mothers and children in situations that can potentially result in severe trauma. No conflict of interests was declared by the authors.