Fetal head delivery assisted with large S hook combined with the modified ingenious technique in cesarean section

GUO Yan; YU Xinying; LU Jing; CHEN Pinghua; LI Shuping

doi:10.3969/j.issn.2095-8331.2025.05.006

Abstract：Under the background of our country's full implementation of the two-child policy and the rising proportion of advanced maternal age and high-risk pregnancies in obstetric clinical practice,as of 2025,the rate of cesarean sections in China still remains high.According to recent statistics,the national average rate of cesarean sections is approximately 46.5%,with some regions even reaching 60%to 80%.In Changzhou,the rate of cesarean sections is also over 40%.During cesarean sections,The ingenious application of the large S hook combined technique to assist in the delivery of the fetal head is a practical technique,and has significant advantages,especially when the fetal head is high and floating,deeply embedded,or when it is difficult to expose the surgical field.Compared with the traditional single technique,forceps delivery and fetal aspiration in cesarean section,it has been optimized in reducing fetal head delivery time,intraoperative bleeding,distal uterine incision dilation,and fetal birth injury.By using the 3/8 arc of the large S hook,the surgeon and assistant can flexibly adjust the pressure direction according to the specific situation during the operation,ensuring that the fetal head is delivered along the optimal path.The surgeon needs to precisely control the depth and angle of the S hook to avoid excessive pulling and reduce the risk of uterine incision extension.This technique is particularly applicable to obese parturients with BMI>28,and those with complex conditions,such as high fetal head,repeated or multiple cesarean sections,poor elasticity of scar tissue,etc.It can significantly enhance surgical safety and optimize maternal and infant outcomes.