Simulation of an Instrumental Childbirth for the Training of the Forceps Extraction: Control Algorithm and Evaluation

Moreau, Richard; Pham, Minh Tu; Brun, Xavier; Redarce, Tanneguy; Dupuis, Olivier

doi:10.1109/titb.2011.2107746

Cited by 12 publications

(6 citation statements)

References 17 publications

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“…Other studies have also recognized a need for improved training in instrumental delivery techniques [28]. While ‘real-life’ experience is desirable, simulator-based training has been developed and may help fulfill some learning needs [29]. …”

Section: Commentmentioning

confidence: 99%

Management of fetal malposition in the second stage of labor: a propensity score analysis

Aiken¹,

Aiken²,

Alberry³

et al. 2015

American Journal of Obstetrics and Gynecology

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Objective To determine the factors associated with selection of rotational instrumental versus cesarean delivery to manage persistent fetal malposition, and to assess differences in adverse neonatal and maternal outcomes following delivery by rotational instruments versus cesarean section. Study Design We conducted a retrospective cohort study over a 5-year period in a tertiary UK obstetrics center. 868 women with vertex-presenting, single, live-born infants at term with persistent malposition in the second stage of labor were included. Propensity-score stratification was used to control for selection bias: the possibility that obstetricians may systematically select more difficult cases for cesarean section. Linear and logistic regression models were used to compare maternal and neonatal outcomes for delivery by rotational forceps or ventouse versus cesarean section, adjusting for propensity scores. Results Increased likelihood of rotational instrumental delivery was associated with lower maternal age (OR= 0.95 p<0.01), lower BMI (OR=0.94 p<0.001), lower birth-weight (OR=0.95 p<0.01), no evidence of fetal compromise at the time of delivery (OR=0.31 p<0.001), delivery during the daytime (OR= 1.45, P<0.05), and delivery by a more experienced obstetrician (OR=7.21 p<0.001). Following propensity score stratification, there was no difference by delivery method in the rates of delayed neonatal respiration, reported critical incidents, or low fetal arterial pH. Maternal blood loss was higher in the cesarean group (295.8± 48ml p<0.001). Conclusions Rotational instrumental delivery is often regarded as unsafe. However, we find that neonatal outcomes are no worse once selection bias is accounted for, and that the likelihood of severe obstetric hemorrhage is reduced. More widespread training of obstetricians in rotational instrumental delivery should be considered, particularly in light of rising cesarean section rates.

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Section: Commentmentioning

confidence: 99%

Management of fetal malposition in the second stage of labor: a propensity score analysis

Aiken¹,

Aiken²,

Alberry³

et al. 2015

American Journal of Obstetrics and Gynecology

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“…Contrary to electric actuators, pneumatic actuators have however a natural compliance which is highly suitable for a realistic haptic feedback. These cylinders have been sized according to the results from [11] and [12] which showed that the maximal applied force to extract the fetus is about 200N. The stroke of these cylinders have been chosen according to the trajectory extracted from Buttin et al [13] which is similar to the one introduced in Fig.…”

Section: A Designmentioning

confidence: 99%

A new design for the BirthSIM simulator to improve realism

Herzig¹,

Moreau²,

Redarce³

2014

2014 36th Annual International Conference of the IEEE Engineering in Medicine and Biology Society

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This paper presents a new design of the BirthSIM simulator. Its goal is to help obstetricians and midwives to train and improve their skills during childbirth delivery. The new version of the BirthSIM is more actuated than the previous version in order to be more biofidelic and cover various scenarios. The direct and inverse geometric models of the haptic interface are presented. The working space reached by the fetal head is computed and validates the proposed design which allows to reproduce all fetal head trajectories inside the pelvis. The novelty is illustrated by an example which presents a simulated trajectory stemmed from a sacrum shape measure. The inverse geometric model allows to compute the actuators displacements and thus to validate the chosen components.

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“…The acquisition of the skills for vacuum application depends on the exposure of junior obstetricians to situations in which they can learn the procedure and train themselves, under the supervision of senior operators [4,5]. The experience of trainees is therefore directly proportional to the number of operative deliveries that take place on patients in the structure where the training takes place.…”

Section: Introductionmentioning

confidence: 99%

Simulation training program for vacuum application to improve technical skills in vacuum-assisted vaginal delivery

Mannella

Giordano

Guevara

et al. 2021

BMC Pregnancy Childbirth

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Objective evaluation of technical skills of the operators during the obstetrical device application for operative vaginal delivery, named kiwi-cup in a simulation training program. Methods Thirty-five residents in obstetrics and gynecology of the University of Pisa, Italy were recruited and evaluated with an assessment scale on technical skills from 0 to 55 points. They performed various operative vaginal delivery simulations with kiwi-cup and were evaluated at time 0 by a tutor. After 8 weeks, simulation training was repeated and trainees were re-evaluated by the same tutor. Results after 8 weeks from the first simulation session, trainees have been shown to increase technical skills (46.27 ± 4.6 with p-value < 0.0001), the successful application rate (85.71% with p-value 0.0161).) and to reduce the time to complete the procedure (86.2 ± 29.9 s with p-value < 0.0001). Conclusion simulation training on operational vaginal delivery significantly increases technical skills, improves successful rate, and reduces the time taken to complete the procedure. Clinical trial registration Not applicable.

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Simulation of an Instrumental Childbirth for the Training of the Forceps Extraction: Control Algorithm and Evaluation

Cited by 12 publications

References 17 publications

Management of fetal malposition in the second stage of labor: a propensity score analysis

Management of fetal malposition in the second stage of labor: a propensity score analysis

A new design for the BirthSIM simulator to improve realism

Simulation training program for vacuum application to improve technical skills in vacuum-assisted vaginal delivery

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