Abstract

Complications during childbirth result in the need for obstetricians to use ‘assisted delivery’ in over 12% of cases. Whilst this is preferable to the risk of maternal and foetal trauma imposed by emergency Caesarian-Section, assisted delivery systems remain poorly understood and under-developed. The aim of this research is therefore to achieve a robust engineering understanding of the key design parameters of commercially available vacuum assisted delivery (VAD) devices and their impact on performance and trauma.

Recently VAD devices have emerged as the instrument of choice for assisted delivery, surpassing forceps due to ease of use, decrease in maternal morbidity and improved cosmetic outcome for the baby. With the growing popularity of VAD, the clinical evidence on the safety and efficacy of such devices still remains unclarified. Despite the high propensity of delivery failures occurring due to VAD cup detachment, there have been no changes in cup design since its original clinical conception by Tage Malmström.

In an effort to understand the drawbacks of the most popular device on the market, the Kiwi OmniCup, an experimental simulation of VAD has been developed; using instrumentation to assess the mechanics of VAD cup detachment. Our simulation features a novel foetal head scalp model with design inputs chosen to reflect the real clinical situation. Results to date have demonstrated that cup detachment can be recreated and successfully characterized during a dynamic loading simulation of overtraction. This knowledge brings the opportunity of quantitatively assessing the efficacy of VAD devices and using this to inform the design of less atraumatic VAD devices.

Additional Information

This presentation was given at the one day symposium, Current Approaches to Understanding Surgical Error, University of Leeds, Leeds, UK, on 9 December 2016.

Conflicts of interest: none declared.

Author affiliations:
Dushyant Goordyal, Ali Alazmani, Peter Culmer: School of Mechanical Engineering, University of Leeds, Leeds, UK