Fetal extraction maneuvers during cesarean delivery
For some years now, in our obstetrics service, some first-year residents and a second-year resident have brought to clinical meetings the difficulty of fetal extraction in cesarean delivery. It is a common difficulty at the beginning of the training of specialists in gynecology and obstetrics, and training in the field becomes difficult and dangerous, generating anguish and a feeling of impotence in the resident physician.
Residents in more advanced years reported that they also had difficulties with difficult fetal extractions such as too tight or too high a fetal presentation.
The team came to the conclusion that the educational need was training in the Geppert maneuver for first-year residents and difficult fetal extraction maneuvers (eg reverse pelvic extraction and Patwardhan technique) for second- and third-year residents.
For that, we designed this simulator that fits into a hard plastic pelvis for vaginal delivery training. This pelvis has to have the abdominal cavity and the pubic symphysis.
Construction
Materials
- 50cm Neoprene fabric (as for wetsuit)
- Zipper
- Elastic bands with good tension of 10 centimeters, 1.5 meters will be needed
- big velcro
- Elastane fabric (to make the abdominal wall)
Instructions
1. Cut 2 pieces of neoprene in the shape of the uterus. Our model has a diameter of 50 centimeters. Think seam allowance of approximately 60 mm.
2. Do the hysterotomy and a hem with a neoprene band to reinforce the hysterotomy, otherwise the model will tear in the simulations.
3. Place the Zipper and place the elastic on top.
4. Place the elastics that will fix the simulator in the pelvis. Don’t forget to sew the Velcro on one of the elastics.
5. Done!! – now it’s just a matter of sewing the sandwich, and turning it around the cervix or the hysterotomy.
Have you made this model or similar?
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