The Effect of Using a Fetal Pillow in Second-Stage Cesarean Sections on Fetal and Maternal Outcomes in Comparison to Other Usual Methods: A Retrospective Study

Objective To evaluate the impact of using the Fetal Pillow on maternal and fetal outcomes during second-stage cesarean sections compared to conventional methods, including vaginal disimpaction, abdominal disimpaction, breech extraction, wound extension, and the use of tocolytics. Methodology This retrospective cohort study analyzed 100 second-stage cesarean sections performed at Queen Elizabeth The Queen Mother Hospital (QEQM) and William Harvey Hospital (WHH) between March 2022 and June 2024. The Fetal Pillow was used in 29 cases, while conventional methods were employed in 71 cases. Maternal outcomes assessed included estimated blood loss (EBL), length of hospital stay, and uterine extensions. Fetal outcomes included Special Care Baby Unit (SCBU) admission, arterial cord pH, and fetal injuries. Results The use of the Fetal Pillow did not result in statistically significant differences in maternal outcomes, including EBL (<i>P</i> = 0.418), hospital stay (<i>P</i> = 0.703), and uterine extensions (<i>P</i> = 0.554). Similarly, there were no significant differences in SCBU admissions (<i>P</i> = 0.578) or arterial cord pH < 7.05 (<i>P</i> = 0.432). However, cases where the Fetal Pillow was used showed a significant increase in fetal injuries such as facial bruises (<i>P</i> = 0.005). Notably, the median EBL and hospital stay were lower in the Fetal Pillow group, although these differences were not statistically significant. Conclusions The use of the Fetal Pillow in second-stage cesarean sections did not result in statistically significant differences in most fetal or maternal outcomes when compared to the conventional methods. However, cases where the Fetal Pillow was utilized demonstrated a lower median EBL and a shorter median hospital stay. The observed increase in fetal injuries associated with the Fetal Pillow seems to be linked to its use after unsuccessful instrumental deliveries. Future research should focus on identifying specific clinical scenarios where the Fetal Pillow can offer maximal benefit while minimizing risks.