Comparing forces on the fetal neck in breech delivery in lithotomy versus all-fours position: a simulation model.
Arch Gynecol Obstet
; 308(1): 91-99, 2023 07.
Article
em En
| MEDLINE
| ID: mdl-35857095
ABSTRACT
PURPOSE:
To measure forces applied to the fetal neck, in a simulation model for breech delivery, in both lithotomy versus all-fours position.METHODS:
We used a Laerdal SimMom simulator and a Birthing Baby together with PROMPT Flex Software. The descent of the fetus was accomplished using the Automatic Delivery Module 2. The baby was always in breech position; the SimMom in either all-fours or lithotomy positions. Sensors were located inside the fetal neck region to simulate forces applied to the plexus.RESULTS:
The lowest force on the fetal neck region was recorded for the delivery in all-fours position without further maneuvers (mean force 58.70 Newton, standard deviation 2.54 N). As weight was added to the baby, the force increased (i.e. + 500 g, mean force 71.8 N, SD 3.08 N, p < 0.001). Delivery in lithotomy position resulted in a mean force of 81.56 N (SD 19.55 N). The force significantly increased in case of delivery of the head without assistance from contractions (mean force 127.93 N, SD 23.10 N). In all-fours position, the delivery of the fetal head from pelvic floor level without contractions (Frank's Nudge maneuver) resulted in a mean force of 118.45 N (SD 15.48 N, p = 0.02). Maneuvers for shoulder dystocia (the inverted type that can occur during breech delivery) led to significantly higher mean forces independent from birthing positions.CONCLUSION:
Breech delivery in all-fours position was associated with the lowest force acting on the fetal neck in our simulation model.Palavras-chave
Texto completo:
1
Coleções:
01-internacional
Base de dados:
MEDLINE
Assunto principal:
Apresentação Pélvica
/
Distocia
/
Distocia do Ombro
Limite:
Female
/
Humans
/
Pregnancy
Idioma:
En
Revista:
Arch Gynecol Obstet
Assunto da revista:
GINECOLOGIA
/
OBSTETRICIA
Ano de publicação:
2023
Tipo de documento:
Article
País de afiliação:
Alemanha