Hemorrhage is one of the main causes of maternal death in Brazil and worldwide. Most hemorrhage deaths can be prevented with proper management. Postpartum bleeding (normal delivery or caesarean section) is often associated with uterine atony. Training in the proper management of postpartum hemorrhage can save lives. The use of simulations for this training is effective and improves the performance of the teams.

The proposed model allows the training of uterine massage (initial measure), bimanual uterine massage (contemporary measure) and tamponade balloon insertion (Foley probe + condom). The model can be used alone, adapted in existing pelvic simulators or dressed by an actress/student.

Goals

• Simulation of the resuscitation of a patient with postpartum hemorrhage
• Uterine massage simulation
• Bimanual uterine massage simulation
• Simulation of the use of tamponade balloon
• Teamwork skills training, resuscitation
• Discussion about the patient’s vision, sensations, communication in emergency situations.

Making the model:

This work is licensed under a License Creative Commons – Atribuição-CompartilhaIgual 4.0 Internacional.

Material

Material

• 1 piece of Neoprene – neoprene is that fabric used to make surf clothes and those thermal lunch boxes. You can buy them in specialized stores – I bought half a meter and it was enough to make 3 models.
• Scissors
• Pen to mark
• Bowl or dish 20 cm in diameter
• 300 ml PET bottle
• Thin nylon rope (approximately 40 cm)
• Thick Velcro (10 cm)
• Sewing machine
• Line and needle
• Small plastic beach ball with deflation pin.

Step by step

Mark the drawing of the uterus with the bowl or plate. Remember to leave the neck a little longer. Don’t worry too much about symmetry.

 

Also cut two 12×10 cm rectangles (vaginal walls) and two 10×7 cm rectangles (vulva).

2 rectangles of 12×10 (vaginal walls).

Let’s sew.

Now you can sew the uterine bodies – right sides together and remember to cut some little triangles on the edges to shape them later.

Now we are going to place the vaginal walls (remember that they must be placed above the cervix and that the red part is towards the inside).

Repeat the process on the other side.

Now, let’s pass the threads, which “close” the cervix and allow to place the PET bottle to pass the balloon.

Pass the wires – the wires go in and out on the same side 2x.

Now just sew one vaginal wall to the other.

All that remains is to place the flaps that will be the vulva.
Apply Velcro to each flap – the “hardest” part of the Velcro.
The softest part, apply to a pair of shorts or pants, next to the vaginal opening.

The model is ready.
To do most simulations, it is necessary to access the uterine cavity.

Therefore, make a cut in the uterine body.

Opening on one side of the uterine body

 

 

Now that we have the model done, let’s discuss some uses.

Uterine Massage

For uterine massage training, place the deflated beach ball inside the model.

 

The Model with the ball can be used “loose”, or placed in previously prepared shorts.

In uterine massage training, while the student is doing the massage, the deflated ball can be squeezed from behind by the “laboring woman” or by an instructor. This causes the uterus to have the proper contraction consistency.

The model with the ball allows the training of uterine massage and bi-manual uterine massage.

 

Insertion of the Intra Uterine Balloon.

For this procedure, place a PET bottle on the model. Secure in the lap with the passed threads.

(I have demonstrated how the model looks with the PET bottle outside the model, and then inside).

Other uses

The model also allows to simulate

• Retained placenta with closed and open cervix
• Uterine inversion

Have you made this model or similar?

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