Characterising Forces Applied During the Simulated Management of Impacted Fetal Head: Pre-Clinical Methods Study.

Abstract

Evaluate whether a sensorised surgical glove can serve as an effective training tool in management of impacted fetal head; and improvements needed. Examine location and amount of force applied through operators' hands during simulated disimpaction. Feasibility study. National course of rotational vaginal birth and complex caesarean birth. Obstetricians of varying seniority. Fetal head disimpaction using a model while wearing a sensorised glove. Maximum and time-averaged force data were captured by 12 sensors, including the location of force. Thematic analysis of free-text answers to questionnaires. Sensorised glove's training effectiveness, force location and amount; and themes derived from free-text answers. 13 obstetricians of varying seniority participated. One was considered an expert, and their performance was used as a reference point. Fingertip sensors: highest maximum force values, consistently across participants. Palmar sensors: relatively high peak forces, greater variability. Dorsal sensors: lower forces overall, high variability. Force during fetal disimpaction was applied in brief, targeted bursts (maximum) rather than continuously (time-averaged). Desirable improvements identified included: making the glove wireless, avoiding the need to triple glove and a standardised model. A sensorised glove has been developed, and participants found potential for use in training and management of impacted fetal head. There was consistent use of fingertips to deliver force, perhaps due to their precision and control. Variability in dorsal and palmar regions uncovered differences in hand positioning and technique.