studies being done for SD
Re: studies being done for SD
Here's the site, you can watch a video clip of the prototype and it's uses....
http://www.jhu.edu/news_info/news/audio ... hands.html
http://www.jhu.edu/news_info/news/audio ... hands.html
Re: studies being done for SD
Wow. That's great. And they created this in one semester. Wonder why no one thought of that a long time ago.
-
Kath
- Posts: 3242
- Joined: Mon Nov 18, 2002 4:11 pm
- Injury Description, Date, extent, surgical intervention etc: I am ROBPI, global injury, Horner's Syndrome. No surgery but PT started at 2 weeks old under the direction of New York Hospital. I wore a brace 24/7 for the first 11 months of my life. I've never let my injury be used as an excuse not to do something. I've approach all things, in life, as a challenge. I approach anything new wondering if I can do it. I tried so many things I might never have tried, if I were not obpi. Being OBPI has made me strong, creative, more determined and persistent. I believe that being obpi has given me a very strong sense of humor and compassion for others.
- Location: New York
Re: studies being done for SD
Allison
thanks so much for posting. It give us so much hope for the future. This is so amazing and education is the key to prevention.
I thought I read about project in England that was similar. But I could be mistaken. Some one from the UK might know... Karen where are you?
Kath
thanks so much for posting. It give us so much hope for the future. This is so amazing and education is the key to prevention.
I thought I read about project in England that was similar. But I could be mistaken. Some one from the UK might know... Karen where are you?
Kath
Kath robpi/adult
Kathleen Mallozzi
Kathleen Mallozzi
Re: studies being done for SD
I e-mailed Dr Gurewitsch and thanked her for her efforts. Anyone care to join me? Her e-mail is listed below.
Edith D. Gurewitsch, MD
The Johns Hopkins Hospital
Phipps 217
600 North Wolfe Street
Baltimore, MD 21287
Phone: 410-955-8297
Fax: 410-614-8305
E-mail:
egurewi@jhmi.edu
Project Title: Preventing Unintentional Mechanical Birth Injuries
Project Period: 8/1/04–7/31/07
Description: The objective of this project is to elucidate mechanisms involved in mechanical birth injuries that occur following an obstetric emergency known as shoulder dystocia and to develop practical interventions to control or prevent such injuries, some of which can lead to lifelong disability. Affecting up to 15% of vaginal deliveries, shoulder dystocia is a naturally occurring mechanical obstruction in which, after the head delivers, the fetal shoulders become impacted behind the mother’s pubic bone and the trunk cannot deliver without specific intervention by the clinician who must act quickly to prevent asphyxia while simultaneously avoiding undue stretch on the fetal neck. The latter can result in skeletal fractures and brachial plexus nerve injury—unintended outcomes of up to nearly 30% of shoulder dystocias. Standard obstetric maneuvers used to resolve shoulder dystocia involve manipulation of either the mother or the fetus. Although the superiority of one maneuver over another has not been proven, biomechanical considerations support the hypothesis that fetal manipulation requires 20% to 30% less force to deliver the infant than maternal manipulation and, if prioritized, could reduce the incidence of injury. However, most clinicians are less familiar with fetal maneuvers and defer their use in favor of repeating maternal ones.
The goals of this research are to demonstrate the mechanical advantage of fetal manipulation over maternal manipulation in accomplishing atraumatic resolution of shoulder dystocia and to familiarize clinicians with fetal maneuvers as a public health measure to reduce and prevent neonatal injury. To achieve these objectives, biomedical engineering will be integrated with clinical obstetrics through five specific aims:
1. Measure clinician-applied traction on the fetal head using a custom-designed shoulder dystocia birthing simulator and correlate direction, magnitude, and rate of this force with fetal neck extension, flexion, and rotation; brachial plexus stretch; and skeletal fracture.
2. Assess objectively, in a laboratory setting, the effect of uterine and maternal expulsive forces and of different shoulder dystocia maneuvers on clinician-applied force, fetal neck motion parameters, and brachial plexus stretch.
3. Conduct an educational program for clinicians on the performance of shoulder dystocia maneuvers, employing the laboratory simulator and force-measuring systems, and assess its effect on clinicians’ ability to estimate the amount of traction they apply during delivery.
4. Measure clinician-applied traction in vivo and compare this with laboratory-derived force parameters.
5. Conduct a small, randomized clinical trial comparing clinician-applied forces following McRoberts’ maneuver (a maternal manipulation) and following Rubin’s maneuver (a fetal manipulation
Edith D. Gurewitsch, MD
The Johns Hopkins Hospital
Phipps 217
600 North Wolfe Street
Baltimore, MD 21287
Phone: 410-955-8297
Fax: 410-614-8305
E-mail:
egurewi@jhmi.edu
Project Title: Preventing Unintentional Mechanical Birth Injuries
Project Period: 8/1/04–7/31/07
Description: The objective of this project is to elucidate mechanisms involved in mechanical birth injuries that occur following an obstetric emergency known as shoulder dystocia and to develop practical interventions to control or prevent such injuries, some of which can lead to lifelong disability. Affecting up to 15% of vaginal deliveries, shoulder dystocia is a naturally occurring mechanical obstruction in which, after the head delivers, the fetal shoulders become impacted behind the mother’s pubic bone and the trunk cannot deliver without specific intervention by the clinician who must act quickly to prevent asphyxia while simultaneously avoiding undue stretch on the fetal neck. The latter can result in skeletal fractures and brachial plexus nerve injury—unintended outcomes of up to nearly 30% of shoulder dystocias. Standard obstetric maneuvers used to resolve shoulder dystocia involve manipulation of either the mother or the fetus. Although the superiority of one maneuver over another has not been proven, biomechanical considerations support the hypothesis that fetal manipulation requires 20% to 30% less force to deliver the infant than maternal manipulation and, if prioritized, could reduce the incidence of injury. However, most clinicians are less familiar with fetal maneuvers and defer their use in favor of repeating maternal ones.
The goals of this research are to demonstrate the mechanical advantage of fetal manipulation over maternal manipulation in accomplishing atraumatic resolution of shoulder dystocia and to familiarize clinicians with fetal maneuvers as a public health measure to reduce and prevent neonatal injury. To achieve these objectives, biomedical engineering will be integrated with clinical obstetrics through five specific aims:
1. Measure clinician-applied traction on the fetal head using a custom-designed shoulder dystocia birthing simulator and correlate direction, magnitude, and rate of this force with fetal neck extension, flexion, and rotation; brachial plexus stretch; and skeletal fracture.
2. Assess objectively, in a laboratory setting, the effect of uterine and maternal expulsive forces and of different shoulder dystocia maneuvers on clinician-applied force, fetal neck motion parameters, and brachial plexus stretch.
3. Conduct an educational program for clinicians on the performance of shoulder dystocia maneuvers, employing the laboratory simulator and force-measuring systems, and assess its effect on clinicians’ ability to estimate the amount of traction they apply during delivery.
4. Measure clinician-applied traction in vivo and compare this with laboratory-derived force parameters.
5. Conduct a small, randomized clinical trial comparing clinician-applied forces following McRoberts’ maneuver (a maternal manipulation) and following Rubin’s maneuver (a fetal manipulation
-
Karen Hillyer
- Posts: 562
- Joined: Fri Sep 06, 2002 1:36 pm
Re: studies being done for SD
Hi Kath and Alison
you are quite correct Dr Tim Draycott a consultant obstetrician in the Uk has been working on a mannequin with moveable legs and simulated uterus for about 5 years now - during the course of developing "Nellie" as she is known, it became apparent that staff were unaware of just how much traction was being used when delivering a baby in a birth complicated by SD - so when our UK group donated a sum of money to the research team at the hospital, Dr Draycott used the money to develop an electronic "strain gauge" to measure the amount of traction used.
Our group has been delighted to support the team at Bristol with this project and indeed has presented the mannequin at two of our study days for Midwives and also our AGM to our group members.
I am delighted to report that "Nellie" will be commercially available from next year to hospitals for training purposes - having seen Nellie myself I can tell you that for a training aid, she knocks spots off the traditional training aid, a plastic pelvis and doll (which I notice even the team at JHU were still using in their video!)
I think that the introduction of this type of training device will really benefit the "pregnant community"
Karen
you are quite correct Dr Tim Draycott a consultant obstetrician in the Uk has been working on a mannequin with moveable legs and simulated uterus for about 5 years now - during the course of developing "Nellie" as she is known, it became apparent that staff were unaware of just how much traction was being used when delivering a baby in a birth complicated by SD - so when our UK group donated a sum of money to the research team at the hospital, Dr Draycott used the money to develop an electronic "strain gauge" to measure the amount of traction used.
Our group has been delighted to support the team at Bristol with this project and indeed has presented the mannequin at two of our study days for Midwives and also our AGM to our group members.
I am delighted to report that "Nellie" will be commercially available from next year to hospitals for training purposes - having seen Nellie myself I can tell you that for a training aid, she knocks spots off the traditional training aid, a plastic pelvis and doll (which I notice even the team at JHU were still using in their video!)
I think that the introduction of this type of training device will really benefit the "pregnant community"
Karen