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Analysis of the obstetrician's posture and movements during a simulated forceps delivery

BMC pregnancy and childbirth, 2024-04, Vol.24 (1), p.253-253 [Peer Reviewed Journal]

2024. The Author(s). ;2024. This work is licensed under http://creativecommons.org/licenses/by/4.0/ (the “License”). Notwithstanding the ProQuest Terms and Conditions, you may use this content in accordance with the terms of the License. ;Distributed under a Creative Commons Attribution 4.0 International License ;The Author(s) 2024 ;ISSN: 1471-2393 ;EISSN: 1471-2393 ;DOI: 10.1186/s12884-024-06457-4 ;PMID: 38589802

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  • Title:
    Analysis of the obstetrician's posture and movements during a simulated forceps delivery
  • Author: Sorel, Manon ; Gachon, Bertrand ; Coste-Mazeau, Perrine ; Aubard, Yves ; Pierre, Fabrice ; Fradet, Laetitia
  • Subjects: Biomechanics ; Cameras ; Childbirth & labor ; Delivery, Obstetric ; Extraction, Obstetrical - methods ; Female ; Forceps delivery ; Gynecology and obstetrics ; Human health and pathology ; Humans ; Infant, Newborn ; Injuries ; Life Sciences ; Mechanics ; Motion capture ; Obstetrical biomechanics ; Obstetrical Forceps ; Obstetricians ; Obstetrics ; Physics ; Posture ; Pregnancy ; Traction forces ; Training simulation ; Vagina
  • Is Part Of: BMC pregnancy and childbirth, 2024-04, Vol.24 (1), p.253-253
  • Description: The objective of this study was to identify and qualify, by means of a three-dimensional kinematic analysis, the postures and movements of obstetricians during a simulated forceps birth, and then to study the association of the obstetricians' experience with the technique adopted. Fifty-seven volunteer obstetricians, 20 from the Limoges and 37 from the Poitiers University hospitals, were included in this multi-centric study. They were classified into 3 groups: beginners, intermediates, and experts, beginners having performed fewer than 10 forceps deliveries in real conditions, intermediates between 10 and 100, and experts more than 100. The posture and movements of the obstetricians were recorded between December 2020 and March 2021 using an optoelectronic motion capture system during simulated forceps births. Joint angles qualifying these postures and movements were analysed between the three phases of the foetal traction. These phases were defined by the passage of a virtual point associated with the forceps blade through two anatomical planes: the mid-pelvis and the pelvic outlet. Then, a consolidated ascending hierarchical classification (AHC) was applied to these data in order to objectify the existence of groups of similar behaviours. The AHC distinguished four different postures adopted when crossing the first plane and three different traction techniques. 48% of the beginners adopted one of the two raised posture, 22% being raised without trunk flexion and 26% raised with trunk flexion. Conversely, 58% of the experts positioned themselves in a "chevalier servant" posture (going down on one knee) and 25% in a "squatting" posture before initiating traction. The results also show that the joint movement amplitude tends to reduce with the level of expertise. Forceps delivery was performed in different ways, with the experienced obstetricians favouring postures that enabled observation at the level of the maternal perineum and techniques reducing movement amplitude. The first perspective of this work is to relate these different techniques to the traction force generated. The results of these studies have the potential to contribute to the training of obstetricians in forceps delivery, and to improve the safety of women and newborns.
  • Publisher: England: BioMed Central
  • Language: English
  • Identifier: ISSN: 1471-2393
    EISSN: 1471-2393
    DOI: 10.1186/s12884-024-06457-4
    PMID: 38589802
  • Source: DOAJ : Directory of Open Access Journals
    SpringerOpen
    PubMed Central (Open access)
    Geneva Foundation Free Medical Journals at publisher websites
    Hyper Article en Ligne (HAL) (Open Access)
    MEDLINE
    ROAD: Directory of Open Access Scholarly Resources
    ProQuest Central
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