Obstetric Trauma
Conditions
Brief summary
Operative vaginal delivery is the main risk factor for pelvic floor trauma occurrence and especially for obstetric anal sphincter injuries. These complications are strongly and negatively impact women's health: fecal incontinence, perineal pain, sexual dysfunction. The risk appears higher in case of operative vaginal delivery assisted by forceps compared to a vacuum delivery. This considered it is likely that optimizing the performance of the operator that perform the operative vaginal delivery will reduce the morbidity associated with this intervention. There are data bout how to optimize the placement of the forceps on the fetal head before performing the delivery but there are no data about the movement of the obstetrician during this intervention. The objective is to analyse the posture and the movement of the obstetrician during a simulated forceps operative vaginal delivery using a 3D cinematic analysis. Secondary objectives are to analyse the traction force applied on the forceps during the delivery, to describe the different postures in terms of stability and last to compare the self-declared practice to the objectively observed. This is a prospective study including 40 volunteers (medical doctors and registrars). Each volunteer will perform a simulated operative vaginal delivery using a Suzor's Forceps on a high fidelity mannequin. Postures and movement will be assessed using optometric analysis. The force of traction will be assessed during the operative delivery thank to a force sensor on the forceps. The self declared practice collected thanks to individual questionnaires will be compared to the observed practice during the simulation. The prospects are to identify the best posture and movement for performing an operative vaginal delivery and to promote tools for simulation of medical students.
Interventions
OTHERPosture and movement analysis during a simulated forceps vaginal operative delivery
It will be request from each volunteer to perform a vaginal operative delivery using a Suzor's forceps on a mannequin. The condition will be standardized (anterior occiput low fetal presentation). Each participant will be equipped with 34 reflecting markers allowing to record their movement using infra red cameras (VICON system).
Sponsors
Poitiers University Hospital
Study design
Observational model
OTHER
Time perspective
PROSPECTIVE
Eligibility
Sex/Gender
ALL
Healthy volunteers
Yes
Inclusion criteria
* Medical doctor or registrar that have an experience of operative vaginal delivery using forceps in their clinical activity
Exclusion criteria
* No practice of the forceps at all
Design outcomes
Primary
| Measure | Time frame | Description |
|---|---|---|
| Analysis of the postures and the movement during the simulated operative vaginal delivery | Day of inclusion | measures of angles on joints for the different phases of the operative vaginal delivery |
Secondary
| Measure | Time frame | Description |
|---|---|---|
| Analysis of the traction force during the operative delivery | Day of inclusion | Continuous measure of the traction force during the delivery (in Newton) thanks to a force sensor implemented in the forceps |
| Analysis of the postures in terms of stability | Day of inclusion | Measure of the gravity center projection, the support basis |
| Compare self-declared practice to the observed practice | Day of inclusion | Comparison of the postures self-declared in a questionnaire immediately before the simulation to those observed during the simulation |
Contacts
Primary ContactBertrand GACHON, MD; PhD Student
Outcome results
None listed