Interventional procedure overview of balloon disimpaction of the baby's head at emergency caesarean during the second stage of labour

What the procedure involves

Balloon disimpaction of an engaged baby's head aims to elevate the head, with reduced risk of trauma. It is usually done immediately before an emergency caesarean, at full dilation, during the second stage of labour.

A disposable soft silicone balloon device is inserted into the vagina, using a lubricant. The balloon is pushed back towards the coccyx and placed between the pelvic floor and the baby's head. The balloon surface is placed in contact with the head. The base plate of the device rests on the posterior vaginal wall and anorectum opposite the anococcygeal ligament. This is to prevent downward displacement when the device is inflated. The procedure is similar to the placement of a ventouse cup. Once the device is in position, the balloon is inflated using sterile saline using a tube connected to a 2-way tap. The balloon is designed to inflate only in an upward direction. Inflating the balloon helps to elevate the head out of the pelvis by a few centimetres. The intention is to make the delivery easier with less manipulation through the abdominal wound and to reduce the risk of injury. Immediately after delivery the balloon is deflated by opening the 2-way tap, and the device is removed from the vagina by traction. Following the caesarean, the vagina is inspected for trauma.