EP1649438A2 - Functional and anatomical delivery simulator - Google Patents
Functional and anatomical delivery simulatorInfo
- Publication number
- EP1649438A2 EP1649438A2 EP04767933A EP04767933A EP1649438A2 EP 1649438 A2 EP1649438 A2 EP 1649438A2 EP 04767933 A EP04767933 A EP 04767933A EP 04767933 A EP04767933 A EP 04767933A EP 1649438 A2 EP1649438 A2 EP 1649438A2
- Authority
- EP
- European Patent Office
- Prior art keywords
- fetal
- maternal
- simulator
- fetal head
- behavior
- 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.)
- Withdrawn
Links
Classifications
-
- G—PHYSICS
- G09—EDUCATION; CRYPTOGRAPHY; DISPLAY; ADVERTISING; SEALS
- G09B—EDUCATIONAL OR DEMONSTRATION APPLIANCES; APPLIANCES FOR TEACHING, OR COMMUNICATING WITH, THE BLIND, DEAF OR MUTE; MODELS; PLANETARIA; GLOBES; MAPS; DIAGRAMS
- G09B23/00—Models for scientific, medical, or mathematical purposes, e.g. full-sized devices for demonstration purposes
- G09B23/28—Models for scientific, medical, or mathematical purposes, e.g. full-sized devices for demonstration purposes for medicine
- G09B23/281—Models for scientific, medical, or mathematical purposes, e.g. full-sized devices for demonstration purposes for medicine for pregnancy, birth or obstetrics
Definitions
- the present invention relates to a childbirth simulator.
- International application WO 03/001482 describes a simulator comprising an actuator arranged to simulate the movements of the fetus in the uterus during childbirth.
- a sophisticated delivery simulator facilitating and improving the learning of gestures and obstetric techniques, diagnostic and therapeutic procedures for childbirth, making it possible to prepare parturient women for childbirth and to test and validate clinical procedures or instruments used during certain deliveries.
- the subject of the invention is a birthing simulator which can be characterized by the fact that it comprises: - a fetal system intended for simulate the behavior of at least part of a fetus during childbirth, - a maternal system intended to simulate the behavior of at least part of the maternal body interacting with the fetus, this maternal system comprising at least one membrane subject to fluid pressure.
- the membrane (s) of the maternal system can be made of a flexible and deformable material, and make it possible to simulate the behavior of maternal muscles or maternal internal cavities, in particular the pelvic muscles, the uterus, the bladder or others still .
- the simulator may include a pneumatic or hydraulic device arranged to subject the membrane or membranes of the maternal system to a predetermined pressure during a simulated delivery, by sending a fluid into this or these membranes.
- the fluid pressure may vary during the simulation.
- uterine contractions occur and abdominal pressure can be exerted.
- the pressure to which is or are subjected this or these membranes can vary greatly, with in particular pressure peaks, in order to simulate each uterine contraction and / or each abdominal pressure, as well as cervical dilation.
- the fetal system comprises at least one fetal head which can be made of a semi-rigid, deformable material, of morphology similar to a fetal skull.
- the fetal system may also include a fetal body.
- the maternal system may include a part simulating a bony pelvis.
- the maternal and fetal systems are preferably made from biomimetic materials.
- the maternal and fetal systems can be arranged so as to be interchangeable with other maternal and fetal systems, so as to allow the learning of childbirth on different morphologies of maternal and fetal systems.
- the invention relates to a childbirth simulator which can be characterized by the fact that it comprises: - a fetal system comprising at least one fetal head, this fetal system being intended to simulate the behavior of at least a part of a fetus, - a maternal system intended to simulate the behavior of at least a part of the maternal body interacting with the fetus, and a device making it possible to know the position at least one point, and preferably the position of at least two, even three points, or even the whole, of the fetal head and / or at least one obstetrical instrument.
- position of the fetal head is meant at the same time its position in space, with respect to the maternal system, but also its orientation in space with respect to the maternal and fetal systems.
- the obstetric instrument can be a forceps, a suction cup, or a spatula, or any type of extraction, diagnostic and / or obstetrical instrument.
- the device making it possible to know the position of at least one point of the fetal head and / or of an obstetric instrument may comprise at least one transmitter or locating element positioned on the fetal head and at least one corresponding detector or associated fixed element the locating element placed at a distance from the fetal head, or vice versa, or any other type of sensor making it possible to position the head in space.
- the transmitter can generate, for example, a magnetic or electromagnetic field.
- the device making it possible to know the position of at least one point of the fetal head and / or of at least one obstetrical instrument can also comprise at least one camera and an image analysis system.
- the device making it possible to know the position of at least one point of the fetal head and / or of at least one obstetrical instrument can in particular comprise at least two cameras arranged so as to determine, by triangulation, the position of the fetal head and / or the obstetric instrument.
- the invention relates to a delivery simulator which can be characterized by the fact that it comprises: - a fetal system comprising at least one fetal head, this fetal system being intended to simulate the behavior of at least part of a fetus, the fetal head being connected to an actuator arranged to exert a force on the fetal head , and - a maternal system intended to simulate the behavior of at least one part of the maternal body interacting with the fetus.
- the childbirth simulator allows, thanks to the actuator, to simulate the forces exerted on the fetal head during childbirth, in particular a force helping the expulsion of the fetus, for example during contraction or abdominal pressure, or opposite force.
- the actuator may for example comprise a hydraulic, pneumatic or electric actuator, whether or not controlled to perform constant resistance to advancement or a constant forward speed programmed.
- This cylinder can itself be movable in space along two or three axes making it possible to modify the axis of the cylinder.
- the simulator can also include a device for positioning the fetal head, in particular a mechanical or electromechanical device making it possible to place the head in a predetermined location and orientation, before or at the start of a simulation.
- the fetal head positioning device can be manual or automatic. It may for example include a flexible, an articulation such as a partial or complete ball joint making it possible to modify, with at least one degree of freedom, the position of the fetal head.
- the simulator includes both a device making it possible to know the position of at least one point of the fetal head and a positioning device, it is for example possible to reproduce the same positioning of the fetal head at the start of each simulation , which can put several doctors or midwives in the same situation.
- At least one zone of the fetal system may comprise at least one pressure sensor, arranged to deliver information relating to the pressure exerted on this zone, by another zone of the fetal system, by the maternal system or by a foreign element. , for example by hand or instrument.
- At least one zone of the maternal system may likewise include at least one pressure sensor arranged to deliver information relating to the pressure exerted on this zone by another zone of the maternal system, by the fetal system or by a foreign element such as than a hand or an instrument.
- the simulator may include a pressure measurement device, arranged to process information delivered by this or these pressure sensors.
- One advantage of having pressure sensors on the maternal and fetal systems is that it makes it possible to record the locations on which the doctor or midwife exerts pressure and possibly to measure this pressure, in order to monitor the gestures practiced, and possibly their sequence.
- a pressure sensor can be placed on at least one area of the maternal and fetal systems chosen from the following: sacred promontory, right or left sciatic spine, named lines, large or small fontanel, chin, nose, right orbit, left orbit, or other area of clinical interest.
- the simulator advantageously includes a processing system for controlling the various active elements of the simulator, in order to simulate normal or pathological delivery.
- the processing system may include computer means such as a microcomputer and the appropriate interfaces for controlling the active elements and receiving analog or digital signals and data.
- the processing system can be connected to the aforementioned actuator and control the force exerted by the actuator during the simulation and which may correspond to a resistance movement or to a thrust.
- the processing system can also be connected to the positioning device in order, for example, to control the positioning of the fetal head at the start of the simulation.
- the treatment system can be connected to the device making it possible to know the position of at least one point of the fetal head and / or at least one obstetrical instrument and to be arranged to receive and process, for example in real time, information relative to the position including the orientation of the fetal head and / or the obstetric instrument during the simulation.
- the device for measuring the interface pressure can be connected to the treatment system, the latter being arranged to cause the display, for example, of a map of the pressures exerted on the fetal head.
- the processing system may include an input device, for example a keyboard and / or a mouse, making it possible in particular to enter information relating to the simulation and / or to the person exercising on the simulator.
- the simulator may also include at least one loudspeaker connected to the treatment system, the latter being arranged to transmit sound signals to it, for example noises or cries simulating those of a real birth, or instructions or advice, at the start or during the simulation for example.
- the simulator preferably comprises a display device arranged to display information relating to the simulation of childbirth in the form in particular of images and / or of continuous or intermittent light signals.
- the display device can display in real time information on the progress of the delivery, for example one or more images or data relating to the positioning of the fetal head, one or more images relating to the interface pressures exerted on the one and / or the other of the maternal and fetal systems, information relating to the development of contractions and / or abdominal pressure.
- information relating to the progress of the contractions may be apparent on a paper tracer as during actual delivery.
- the paper tracer can for example be connected to the processing system, which can be arranged to cause the tracing of contractions according to the simulation.
- the invention also relates to an assembly comprising a childbirth simulator as defined above and an obstetric instrument, in particular a forceps, this instrument being able to be provided with at least one pressure sensor.
- the obstetric instrument can be connected to the treatment system.
- the treatment system can be arranged to receive and process the information delivered by the pressure sensor or sensors, in particular concerning the pressures exerted by the obstetrical instrument on the fetal system. Thanks to the invention, a person practicing on the simulator can safely carry out manipulations with an obstetrical instrument, these manipulations being often difficult and risky in reality. We can also test a new obstetric instrument on the birthing simulator.
- the simulator according to the invention can also be used for the preparation of parturient women for childbirth, by visualizing a simulated childbirth.
- the birthing simulator according to the invention can also be used to train doctors and midwives in childbirth, in particular to train them: in gestures of maternal monitoring among which one can cite the diagnosis of the degree of cervical dilation, placement of an instrument in the pelvic canal or uterus such as the internal tocometer; gestures for monitoring the fetus, for example the fitting of a scalp electrode, saturometer, fetal pulse oximeter, or other instruments in contact with the fetus, diagnosis of fetal presentation or diagnosis of the degree of head down; manual obstetric maneuvers, for example the Jacquemier maneuver, the great extraction of the seat, the uterine massage; instrumental obstetrical maneuvers, using for example suction cups, forceps, spatulas; to maneuvers performed after childbirth, such as artificial delivery or uterine revision.
- FIG. 1 is a view schematic and partial, in section, of an example of childbirth simulator according to the invention
- - Figure 2 is a perspective view, schematic and partial, of an example of simulator according to the invention
- - Figure 3 shows, schematically and partially, an example of a device for positioning the fetal head, - FIG.
- FIGS. 1 and 2 show certain elements constituting a birthing simulator 1 produced in accordance with the invention.
- This simulator 1 comprises a fetal system 2 intended to simulate the behavior of at least a part of the fetus during childbirth, and a maternal system 3 intended to simulate the behavior of at least a part of the maternal body interacting with the fetus .
- a treatment system 40 shown diagrammatically in FIG. 4, makes it possible to control the operation of the simulator 1. In the example of FIGS.
- the fetal system 2 comprises a fetal head 4, but it can also include a body fetal without departing from the scope of the present invention.
- the maternal system 3 comprises, in the example under consideration, flexible inflatable membranes 5, two in number, intended to simulate the behavior of the pelvic muscles.
- the maternal system 3 also includes a part 6 intended to simulate the behavior of a female osseous pelvis, with extensions 16 corresponding to the legs. This part 6 has an opening 13 through which the fetal system 2 can be expelled.
- a positioning device 7 for the fetal head 4 makes it possible to modify the position of the fetal head 4 at any time.
- the actuator 8 comprises, in the example considered, a pneumatic cylinder comprising a cylinder body 9 and a pump 10 supplying the pressure necessary for actuating the cylinder.
- the membranes 5 of the maternal system 3 are subjected to the pressure of a fluid, of air in the example considered, thanks to a pneumatic device 11 to which they are connected via respective valves 14 and a conduit 15.
- the pneumatic device 11 is controlled by the treatment system 40, and makes it possible to send a fluid into the enclosures delimited by the membranes 5 under a predefined pressure, this pressure can vary during the simulation of childbirth, so as to simulate the behavior of the maternal muscles.
- the birthing simulator 1 rests on a support 12 which can be a table for example.
- the positioning device 7 is arranged to allow the position of the fetal head 4 to be modified as desired by the user, in particular at the start of a childbirth simulation.
- the positioning device 7 can be manually or automatically controlled. In the case of an automatic control, this can be done through the treatment system 40.
- the actuator 8 is arranged to exert a force on the fetal system 2 going against the expulsion of the fetal system or on the contrary, helping with expulsion, so as to simulate the real forces exerted on a fetus during childbirth, and in particular during uterine contractions or abdominal pressures.
- the actuator 8 can also allow the displacement of the fetal head along a longitudinal axis X, coincident with that of the opening 13 in the example considered. It can be seen on examining FIG. 2 that the valves 14 of the pneumatic device 11 are carried by a support 21 disposed above the membranes 5, so as not to harm the quality of the simulation.
- the fetal head 4 has a morphology and texture similar to that of a fetal skull, being preferably made of a deformable semi-rigid material.
- the membranes 5 and the fetal system 4 are covered with a flexible apron 19 made of transparent polymer, fixed by means of fasteners 20 to the part 6 corresponding to the maternal pelvis.
- This apron 19 can, in a variant not shown, be opaque and / or simulate the behavior of the maternal abdomen.
- the maternal 3 and fetal 2 systems can be exchanged with others, corresponding to different morphologies, not shown.
- the number of membranes 5 can be greater than two, additional membranes can be arranged so as to also simulate the uterus and the bladder, among others.
- the membrane 5 simulating the pelvic muscles extends into the opening 13.
- the positioning device 7 of the fetal head 4 can be produced in different ways.
- the positioning device 7 may include a hose, as illustrated in FIG. 1. It may also include a ball joint or the like.
- FIG. 3 shows a ball joint connected to the fetal head 4.
- the ⁇ otule makes it possible to modify, with several degrees of freedom, the positioning of the fetal head 4. It allows in particular the rotation around an axis Z orthogonal to the plane of the figure and around the longitudinal axis X or the axis Y, perpendicular to the axis X in the plane of the figure.
- the maternal system 3 and the fetal system 2 can each comprise, as illustrated very diagrammatically in FIG. 4, one or more pressure sensors 30. These sensors 30 are connected to a device 31 for measuring the pressure, arranged to receive and process the information delivered by the sensors 30.
- the pressure sensors 30 can be arranged on at least one of the following zones of the maternal system or of the fetal system: the sacred promontory, the right or left sciatic spine, the streaked lines, the large or small fontanelle, the chin, the nose, the right orbit or the left orbit.
- the pressure sensors 30 can be of the single-sensor type, for example strain gauge sensor or contact sensor, or resistive ink sensor or else of the matrix sensor type, for example sensor with charged carbon pellets or pressure sensor. interface. Other types of pressure sensors can be used on the maternal and fetal systems without departing from the scope of the present invention.
- the sensors 3 can also be tactile or other sensors without departing from the scope of the invention.
- the fetal system 2 may further include one or more elements 33 allowing the location of the position of the fetal head and / or an obstetric instrument, such as a forceps.
- a device 34 making it possible to know the position of at least one point of the fetal head and / or of an obstetrical instrument makes it possible to know the position of the tracking elements 33.
- These, three in number in the example illustrated, may for example each include a transmitter of a radiofrequency signal and the device 34 one or more corresponding detectors.
- the device 34 making it possible to know the position of at least one point of the fetal head and / or of an obstetrical instrument can comprise at least two cameras arranged so as to make it possible to determine, by triangulation, the position of the fetal head and / or of the obstetrical instrument, the locating elements 33 comprising for example light emitters or reflective parts.
- the locating elements 33 comprising for example light emitters or reflective parts.
- the processing system 40 may consist of a microcomputer or the like, and also controls a display device 41, a loudspeaker 42 and an input device 43.
- the processing system 40 receives and processes information coming from, of the pressure measurement device 31 and of the device 34 making it possible to know the position of at least one point of the fetal head and / or of an obstetrical instrument.
- the processing system 40 is also arranged to, as mentioned above, control the respective actions of the positioning device of the fetal head 7, of the actuator 8, as well as of the pneumatic device 11.
- the processing system 40 When a person enters, by means of the input device 43, data relating to a simulation to be performed, and in particular gives the order to the processing system 40 to start a predefined simulation, the latter brings the fetal head 4 to a predetermined position, causes the enclosures delimited by filling the membranes 5 at a predetermined pressure and, by means of the actuator 8, applies a predetermined force to the fetal head 4.
- the processing system 40 will cause the display on the display device 41 information relating to the simulation, and for example signaling whether the actions performed by the person exercising on the simulator are correct.
- the display device 41 can display an image or data relating to the positioning of the fetal head, for example 3D images of the fetal head, and / or information on the pressures exerted on the areas on which the pressure sensors 30.
- the display device 41 can also be arranged to display information relating to the development of contractions, and / or abdominal pressure, and / or cervical dilation, in particular graphs allowing monitoring in real-time contractions and / or abdominal pressure, and / or cervical dilation.
- the display device 41 can comprise a screen, for example a computer screen or a video projector, and be placed next to, above or behind the maternal and fetal systems.
- the loudspeaker 42 can broadcast the advice of a trainer or sounds simulating that of childbirth.
- the treatment system 40 can optionally be arranged to evaluate the doctor or the midwife at the end of a childbirth simulation exercise, causing the display of a note or an appreciation.
- the simulator may include an instrument, for example an obstetric forceps, instrumented or not. Certain childbirth simulations, for example stored in the treatment system, may require the use of obstetric instruments, in particular forceps, the use of which involves risks for the fetus.
- the birthing simulator according to the invention allows the use of obstetric instruments. Training in the use of obstetric instruments on the birthing simulator can reduce the risks during a real birth.
- FIG. 5 shows a forceps that can be used with the delivery simulator according to the invention, this forceps being of the type of one that is used during actual deliveries.
- the forceps comprises two spoons 50 symmetrical, coming to bear on the fetal head.
- the latter can be equipped on at least one spoon 50, as illustrated in FIG. 6, with at least one pressure sensor 30.
- the pressure sensor (s) 30 can be arranged on the interior and / or exterior faces of each of the spoons 50. Different types of pressure sensors 30 can be used on instruments without departing from the scope of the present invention. like those that can be used on the maternal and fetal systems. It may however be advantageous to use a matrix sensor as illustrated.
- a forceps equipped with at least one pressure sensor can make it possible in particular to monitor the symmetry of the pressures exerted by the spoons on the fetal head 4, to detect in real time the soft points that the orbits can constitute, for example of the fetal head or hard spots that can constitute bones.
- the invention is not limited to the examples which have just been described. In particular, other obstetric instruments equipped, if necessary, with pressure sensors can be used during a simulation.
- the device for positioning the fetal head 4 may also be different.
- the fetal system may also include a fetal body in addition to the fetal head.
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- General Health & Medical Sciences (AREA)
- Mathematical Physics (AREA)
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- Medicinal Chemistry (AREA)
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- Gynecology & Obstetrics (AREA)
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- Educational Technology (AREA)
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- Instructional Devices (AREA)
- Measuring And Recording Apparatus For Diagnosis (AREA)
- Ultra Sonic Daignosis Equipment (AREA)
- Measurement Of The Respiration, Hearing Ability, Form, And Blood Characteristics Of Living Organisms (AREA)
- Investigating Or Analysing Biological Materials (AREA)
Abstract
Description
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Applications Claiming Priority (2)
Application Number | Priority Date | Filing Date | Title |
---|---|---|---|
FR0309569A FR2858453B1 (en) | 2003-08-01 | 2003-08-01 | FUNCTIONAL SIMULATOR AND ANATOMIC DELIVERY |
PCT/FR2004/050372 WO2005013239A2 (en) | 2003-08-01 | 2004-07-30 | Functional and anatomical delivery simulator |
Publications (1)
Publication Number | Publication Date |
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EP1649438A2 true EP1649438A2 (en) | 2006-04-26 |
Family
ID=34043757
Family Applications (1)
Application Number | Title | Priority Date | Filing Date |
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EP04767933A Withdrawn EP1649438A2 (en) | 2003-08-01 | 2004-07-30 | Functional and anatomical delivery simulator |
Country Status (5)
Country | Link |
---|---|
US (1) | US7651332B2 (en) |
EP (1) | EP1649438A2 (en) |
JP (1) | JP2007501419A (en) |
FR (1) | FR2858453B1 (en) |
WO (1) | WO2005013239A2 (en) |
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2003
- 2003-08-01 FR FR0309569A patent/FR2858453B1/en not_active Expired - Fee Related
-
2004
- 2004-07-30 EP EP04767933A patent/EP1649438A2/en not_active Withdrawn
- 2004-07-30 WO PCT/FR2004/050372 patent/WO2005013239A2/en active Application Filing
- 2004-07-30 JP JP2006521640A patent/JP2007501419A/en active Pending
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2007
- 2007-02-21 US US11/677,204 patent/US7651332B2/en not_active Expired - Fee Related
Non-Patent Citations (1)
Title |
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See references of WO2005013239A2 * |
Also Published As
Publication number | Publication date |
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WO2005013239A2 (en) | 2005-02-10 |
WO2005013239A3 (en) | 2005-07-21 |
FR2858453B1 (en) | 2006-04-28 |
FR2858453A1 (en) | 2005-02-04 |
US7651332B2 (en) | 2010-01-26 |
US20070218442A1 (en) | 2007-09-20 |
JP2007501419A (en) | 2007-01-25 |
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