Symphysiotomy or caesarean section after failed trial of assisted delivery
Mola, G.D.
Papua and new Guinea Medical Journal 38(3): 172-177
1995
ISSN/ISBN: 0031-1480 PMID: 9522856 Document Number: 307757
A retrospective analysis of 65 symphysiotomies and 108 cesarean sections performed in 1988-94 after a failed trial of assisted delivery at the Port Moresby General Hospital (Papua New Guinea) revealed no significant differences in perinatal or maternal outcomes. There were no significant differences between groups in terms of duration of first and second-stage labor, Apgar scores, admission to a special care neonatal unit, or perinatal mortality. There were no maternal deaths. Mothers who had symphysiotomy required a longer hospital stay, but had fewer complications necessitating additional surgery (e.g., wound infection) than women delivered by cesarean section. These findings confirm that, with proper technique and selection of cases, symphysiotomy can both eliminate difficult vaginal deliveries and reduce maternal morbidity and mortality. Indications for this procedure include presentation of the vertex, moderate cephalopelvic disproportion, and a live fetus. The main complications are leg and pelvic pain, pelvic instability, and stress incontinence.