1 Recommendations

1 Recommendations

1.1 Current evidence on the efficacy and safety of inserting a balloon device to disimpact an engaged fetal head before an emergency caesarean section is inadequate in quantity and quality. Therefore, this procedure should only be used with special arrangements for clinical governance and audit or research.

1.2 Clinicians wishing to insert a balloon device to disimpact an engaged fetal head before an emergency caesarean section should take the following actions:

  • Inform the clinical governance leads in advance that they intend to perform the procedure when necessary.

  • Audit and review clinical outcomes of all women treated by the insertion of a balloon device to disimpact an engaged fetal head before an emergency caesarean section (see section 7.2).

1.3 Further research and data collection should report the impact of performing the procedure on the time taken from the decision to perform a caesarean section to delivery of the baby. Technical failures, including the need for repositioning of the device and for subsequent manual disimpaction of the fetal head; and any complications resulting from use of the procedure should be recorded. Fetal outcomes should also be reported. NICE may update the guidance on publication of further evidence.

  • National Institute for Health and Care Excellence (NICE)