EP0290502A1 - Obstetrics cushion. - Google Patents
Obstetrics cushion.Info
- Publication number
- EP0290502A1 EP0290502A1 EP19870907016 EP87907016A EP0290502A1 EP 0290502 A1 EP0290502 A1 EP 0290502A1 EP 19870907016 EP19870907016 EP 19870907016 EP 87907016 A EP87907016 A EP 87907016A EP 0290502 A1 EP0290502 A1 EP 0290502A1
- Authority
- EP
- European Patent Office
- Prior art keywords
- cushion
- thigh pads
- parturient
- obstetrics
- back support
- Prior art date
- Legal status (The legal status is an assumption and is not a legal conclusion. Google has not performed a legal analysis and makes no representation as to the accuracy of the status listed.)
- Granted
Links
Classifications
-
- A—HUMAN NECESSITIES
- A61—MEDICAL OR VETERINARY SCIENCE; HYGIENE
- A61G—TRANSPORT, PERSONAL CONVEYANCES, OR ACCOMMODATION SPECIALLY ADAPTED FOR PATIENTS OR DISABLED PERSONS; OPERATING TABLES OR CHAIRS; CHAIRS FOR DENTISTRY; FUNERAL DEVICES
- A61G15/00—Operating chairs; Dental chairs; Accessories specially adapted therefor, e.g. work stands
- A61G15/005—Chairs specially adapted for gynaecological purposes, e.g. obstetrical chairs
Definitions
- This invention relates to obstetrics.
- an upright position in childbirth offers certain advantages. More particularly, it is thought to promote better alignment of the foetal head with the pelvic inlet to improve the "drive angle" of the pelvis and to lead to stronger and more efficient contractions. There is benefit from the removal (as compared with the supine position) of the weight of the womb from the underlying blood vessels. The force of gravity is made better use of with an upright posture and, finally, it has been shown that with certain upright postures the area of the pelvic outlet is significantly increased. Interest has in recent years revived in a variety of upright postures such as squatting, kneeling, sitting or standing. These postures are referred to in historical works and are also observed in other present-day cultures. In terms of equipment provided for obstetrics use, attention has been primarily focused on the delivery chair which has been put forward as an alternative to the conventional obstetrics bed.
- the pelvic outlet is defined by the transverse separation of the innominate bones and by the an ero-posterior diameter measured from the sy physis of the pelvic bone to the sacrum. It will be recognised that physiological changes in late pregnancy include an increased mouldability of the pelvic joints.
- the joints between the sacrum and the innominate bones have in their upper parts a shallow ball and socket configuration allowing rocking movement of the sacrum.
- the lower part of the joint is flatter and allows for sliding of the sacrum, which is in this region generally wedge-shaped. In a squatting position, leverage from the femora on the innominate bones and weight of the trunk acting through the spine, will have the effect of separating the lower parts of the innominate bones and displacing the lower sacrum backward.
- a sitting position fails to provide or is far less efficient in providing this desirable change in pelvic configuration.
- a substantial portion of trunk weight is supported through the sacrum with a corresponding reduced proportion being supported through the femora.
- the leverage exerted upon the innominate bones is significantly reduced as compared with the squatting position.
- the sacrum may be rotated forward by reaction with the supporting seat surface, leading to a decrease in the antero-posterior diameter which is the opposite to the desired effect. This tilting of the sacrum forward may also pull the lower ends of the innominate bones together so decreasing further the size of the pelvic outlet.
- the present invention consists in one aspect in an obstetrics cushion adapted to be used with a back support, comprising two resilient thigh pads connected in spaced relation so as in use to underlie the parturient's abducted thighs, the cushion being so arranged that the adoption of a squatting position is promoted with a substantial fraction of body weight supported through the femora, the height of the thigh pads being such as to provide a sufficient cavity therebetween for generally vertical delivery of the foetal head.
- the resilient thigh pads are connected by a resilient bridge portion having a front to back dimension which is small compared with the length of the thigh pads.
- the cushion is adapted for use with an obstetric bed having a back support.
- the obstetric bed is ideally height adjustable.
- the cushion can be used with an integral or detachable back support.
- the cushion is provided with handles enabling a force to be exerted through the parturient's arms.
- the present invention consists in an obstetrics cushion adapted to be used with a back support, the cushion comprising a bridge portion formed integrally with two resilient thigh pads extending therefrom so as in use to underlie the parturient's abducted thighs, the bridge portion having a front to back dimension which is small compared with the ⁇ length of the thigh pads, so that adoption of a squatting position is promoted with a substantial fraction of body weight supported through the femora, the height of the thigh pads being such as to provide a sufficient cavity above the bed surface for generally vertical delivery of the foetal head.
- the cushion is formed of plastics foam material having a fluid-tight skin.
- Figure 1 is a side view of an obstetrics cushion according to this invention with a diagrammatic representation of an obstetrics bed;
- Figure 2 is a front elevation
- Figure 3 is a plan view in direction A of Figure 1.
- Figure 4 is a perspective view of an obstetrics cushion according to this invention.
- Figures 5 and 6 are sketches illustrating use of the cushion shown in Figure .
- the obstetrics cushion shown generally at 10 in the drawings is formed of relatively firm plastics foam covered with a skin of impervious PVC or other suitable material providing a fluid-tight skin.
- the grade of foam used in this example is FL35F-
- the cushion comprises a bridge portion 12 formed integrally with thigh pads 14 and 16. Between the thigh pads, there is defined a cavity which is generally parabolic in plan.
- the front-to-back dimension of the bridge portion 12 is seen to be considerably less than the length of the thigh pads. In the described example, the ratio of these dimensions is approximately 1:3 and a ratio of at least 1:2 is preferred.
- the cushion when viewed in side elevation as in Figure 1 takes the form, of a trapezium with the angle of inclination of the parallel generally upright edges being selected to match a typical angle between bed surface l ⁇ and back support surface 20.
- the upper surface of the cushion is arranged to slope downwardly and rearwardly.
- the cushion may be provided with a strap (not shown) fastened to the back support 20 and secured to the cushion through a burr-type fastener to prevent slippage of the cushion away from the back support.
- the relatively thin bridge portion 12 undergoes significantly greater vertical compression than the extensive thigh pads 14 and 16. With abduction of the thighs encouraged by the wide spacing of the thigh pads, this compressibility promotes a squatting or near squatting position in which there is relatively little trunk weight supported through the sacrum and a relatively large fraction of trunk weight supported through the femora. Weight is taken mainly through the femora through the thigh pads and, to a smaller extent, through the feet acting on the bed surface. If the parturient is encouraged to slide forwardly away from the bridge portion this weight transfer is accentuated.
- the squatting or near squatting position provides the advantages outlined above.
- Leverage in the femora acts to separate the pubic bones to increase the transverse diameter of the pelvic outlet and also the angle between the innominate bones. Not only is the sacrum no longer pushed forward, the movement of the innominate bones and the nature of the sacro-iliac joint also serve to move the sacrum backwards to increase the antero-posterior diameter. It should be recognised, however, that these improvements in pelvic configuration are achieved with the parturient retaining the comfort and the freedom to shift position offered by a bed and the benefit of other features of a delivery bed, particularly height adjustability. The resilience of the cushion according to this invention also increases comfort. If thought desirable, a support may be provided over the bed at a height at which it can be gripped by the hands.
- the obstetrics cushion according to this invention can be manufactured inexpensively and it becomes feasible for an obstetrics department to have a cushion for each bed.
- the sealed nature and uncluttered contours of the cushion facilitate thorough cleaning. If it becomes necessary for the parturient to adopt a supine position, the cushion may simply be removed.
- a further advantage as compared with birth chairs is that the baby is delivered onto the bed surface.
- the bed may be provided with side handles below the cushion enabling the parturient to pull herself downwards, effectively increasing body weight and accentuating the described leverage effect in the femora.
- handles 30 are provided with padding 32 and are supported by an internal frame (not shown) .
- Figure 5 illustrates a rest position, whilst it is seen from Figure 6 that pulling on the handles 30 allows the maternal pushing to be directed downwards in the direction of the birth canal. This has been shown to help the parturient woman to co-ordinate the pushing efforts in the second stage of labour.
- the front-to-back dimension of the bridge portion of the cushion is small compared to the length of the cushion thigh pads to promote the described weight transfer.
- the exact shape of the cushion can, however, be varied.
- the outlet of the birth canal is elevated above the bed because of the height of the cushion and this, together with the U-shaped configuration of the thigh pads allows the birth attendant good access for controlling the delivery and room for lateral flexion of the baby's shoulders.
- the actual thickness of the cushion can, however, be " varied and will be selected in combination with the compressibility.
- a variety of materials can be used to produce the cushion although foamed plastics are felt to offer advantages.
- the grade of foam can of course be selected as appropriate. It is desirable, but not essential, to provide means for securing the cushion to the bed and the described strap is but one example of such an arrangement.
- the described handles may be provided on the cushion which is for this purpose suitably provided with a rigid base.
- the orientation of the thigh pads may be determined solely through their respective connections with the base so removing the need for a bridge portion of foamed construction.
- the base serves as the bridge and the dimension of the bridge in the supporting surface beneath the pelvis has been effectively decreased to zero.
- This alternative construction with the base serving to connect the two thigh pads may have advantages even where no side handles are provided. Still further means of connecting together the thigh pads may be devised which maintain the desired effect of ensuring that a substantial fraction of the body weight is supported through the femora rather than through the sacrum.
- the cushion according to this invention is provided with an integral or detachable back support enabling use independently of an obstetric bed, in a home delivery for example.
Landscapes
- Health & Medical Sciences (AREA)
- Gynecology & Obstetrics (AREA)
- Life Sciences & Earth Sciences (AREA)
- Animal Behavior & Ethology (AREA)
- General Health & Medical Sciences (AREA)
- Public Health (AREA)
- Veterinary Medicine (AREA)
- Accommodation For Nursing Or Treatment Tables (AREA)
- Cosmetics (AREA)
Abstract
Le coussin obstétrique décrit (10), qui est constitué de mousse ou d'un matériau similaire, permet d'adopter de façon rapide et confortable une position de soutien accroupie durant le travail. Une partie de pont relativement étroite (12) permet une compression verticale, alors que les coussinets plus larges (14, 16) qui soutiennent les cuisses supportent la majeure partie du poids. La force de levier résultante qu'exercent les fémurs sur les articulations de la hanche augmente les dimensions de la sortie pelvienne. Le fait de tirer sur les poignées latérales (30) durant le travail permet à la mère de mieux coordonner ses efforts de poussée et de mieux les diriger vers le bas en direction des voies génitales. Ledit coussin (10) est conçu de sorte qu'il se place aisément contre la tête relevée d'un lit d'accouchement ou contre un coin en mousse. La hauteur et la forme dudit coussin (10) placent les obstétriciens et assistants dans de bonnes conditions pour effectuer l'accouchement dans la position verticale désirée.The obstetric cushion described (10), which is made of foam or a similar material, makes it possible to quickly and comfortably adopt a squatting support position during work. A relatively narrow bridge part (12) allows vertical compression, while the wider pads (14, 16) which support the thighs support most of the weight. The resulting leverage exerted by the femurs on the hip joints increases the dimensions of the pelvic outlet. Pulling on the side handles (30) during labor allows the mother to better coordinate her pushing efforts and to direct them more downward towards the genital tract. Said cushion (10) is designed so that it easily fits against the raised head of a delivery bed or against a foam wedge. The height and the shape of said cushion (10) place obstetricians and assistants in good conditions for carrying out the delivery in the desired vertical position.
Description
Claims
Applications Claiming Priority (2)
Application Number | Priority Date | Filing Date | Title |
---|---|---|---|
GB8626897 | 1986-11-11 | ||
GB868626897A GB8626897D0 (en) | 1986-11-11 | 1986-11-11 | Obstetrics cushion |
Publications (2)
Publication Number | Publication Date |
---|---|
EP0290502A1 true EP0290502A1 (en) | 1988-11-17 |
EP0290502B1 EP0290502B1 (en) | 1993-05-19 |
Family
ID=10607129
Family Applications (1)
Application Number | Title | Priority Date | Filing Date |
---|---|---|---|
EP19870907016 Expired - Lifetime EP0290502B1 (en) | 1986-11-11 | 1987-10-30 | Obstetrics cushion |
Country Status (5)
Country | Link |
---|---|
EP (1) | EP0290502B1 (en) |
AU (1) | AU8153387A (en) |
DE (1) | DE3785926T2 (en) |
GB (1) | GB8626897D0 (en) |
WO (1) | WO1988003401A1 (en) |
Families Citing this family (4)
Publication number | Priority date | Publication date | Assignee | Title |
---|---|---|---|---|
DE4207540C2 (en) * | 1992-03-10 | 1993-12-23 | Donatello Dr Mancarella | Relaxation device for birth preparation |
AU646199B1 (en) * | 1992-11-03 | 1994-02-10 | Wayne David Johnson | Natal chair |
IT201700051540A1 (en) * | 2017-05-12 | 2018-11-12 | Andrea Atzori | SEAT FOR TRAVEL AND BREAKDOWN |
WO2019185971A1 (en) * | 2018-03-29 | 2019-10-03 | Relaxbirth Oy | Multifunctional birthing chair |
Family Cites Families (7)
Publication number | Priority date | Publication date | Assignee | Title |
---|---|---|---|---|
DE220774C (en) * | ||||
GB357321A (en) * | 1930-07-23 | 1931-09-24 | Thomas Smith | A maternity chair |
US2104830A (en) * | 1937-06-09 | 1938-01-11 | Collard Saby Gertrude | Obstetrical chair |
FR2050277A1 (en) * | 1969-07-22 | 1971-04-02 | Faillieres Jean | |
US4080968A (en) * | 1976-10-06 | 1978-03-28 | Nielsen Irene L | Obstetrical support and pan article |
GB2127296A (en) * | 1982-09-27 | 1984-04-11 | Unimed Inc | Apparatus for use in child-birth |
NL8400172A (en) * | 1984-01-19 | 1985-08-16 | Beatrijs Smulders Da Costastra | Support for squatting woman while giving birth - has large side opening and flexible upper part |
-
1986
- 1986-11-11 GB GB868626897A patent/GB8626897D0/en active Pending
-
1987
- 1987-10-30 DE DE19873785926 patent/DE3785926T2/en not_active Expired - Fee Related
- 1987-10-30 EP EP19870907016 patent/EP0290502B1/en not_active Expired - Lifetime
- 1987-10-30 WO PCT/GB1987/000769 patent/WO1988003401A1/en active IP Right Grant
- 1987-10-30 AU AU81533/87A patent/AU8153387A/en not_active Abandoned
Non-Patent Citations (1)
Title |
---|
See references of WO8803401A1 * |
Also Published As
Publication number | Publication date |
---|---|
AU8153387A (en) | 1988-06-01 |
DE3785926T2 (en) | 1993-12-16 |
WO1988003401A1 (en) | 1988-05-19 |
EP0290502B1 (en) | 1993-05-19 |
DE3785926D1 (en) | 1993-06-24 |
GB8626897D0 (en) | 1986-12-10 |
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