Advanced technology in obstetric education: a high-fidelity simulator for operative vaginal delivery.

A high-fidelity simulator is described here, specifically designed for vacuum extraction and forceps delivery training. The main purpose behind its development is to remedy the current limited opportunity for training in operative vaginal delivery (OVD), making it easier for young obstetricians to become proficient in this important area of obstetrics. Its introduction into teaching hospitals and academic departments may also help older obstetricians maintain their own competence during periods of inactivity, ensuring patient safety.

A technological advance for 21st century obstetricians: the electronically-controlled vacuum extractor.

OBJECTIVE: To describe an innovative electronically-controlled vacuum extractor (VE) in detail and to illustrate its performance characteristics, as observed in a laboratory study. DESIGN: Thirty simulated, vacuum-assisted deliveries. MAIN OUTCOME MEASURE(S): (1) The ability to measure in real-time of the pull applied and to sound an alert, when the traction approaches the negative pressure under the cup, to prevent its detachment. (2) The recording and printing of a graphic representation of the pull applied (vacuum delivery graph). (3) The emission of a warning signal when the 15-min time limit of continuous cup application on the fetal scalp, is reached. RESULTS: No cup detachment occurred in any of the 15 vacuum-assisted deliveries, in which traction was kept below the adhesive force of the cup [44 lb (20 kg)], except in three cases, due to loss of negative pressure. In the remaining 15 tests, in which traction was greater than the adhesive force of the cup, "pull-offs" inevitably occurred. Furthermore, upon reaching the 15-min time limit of continuous cup application on the fetal cephalic model, a warning signal was emitted, as programmed. Conclusions We demonstrated that the electronically-controlled VE, with its distinctive pull-sensing handle, performs suitably for its intended purposes. The ability of the modernized device to decrease the incidence of cup detachment, secondary to the inadvertent application of excessive traction, may result in considerable safety, medico-legal and didactic advantages.

The electronically-controlled axis-traction handle: preliminary report.

AIM: The scope of this preliminary report is to illustrate the performance characteristics of an electronically-controlled axis-traction handle. MATERIAL & METHOD: Preclinical testing was conducted with a prototype of the innovative device, using a childbirth simulator. RESULTS: The simulated forceps deliveries demonstrated that the innovative device allows the obstetrician to measure (unencumbered by dials, scales and cable connections) the traction applied, to be alerted when the preset 50 lbs (22.68 kg) safety limit is approached, and to generate a hard copy print-out of the traction data. CONCLUSION: The electronically-controlled axis-traction handle represents a major technologic advance, that could help improve the training and safe practice of forceps deliveries.