A new approach to assessing the obstetrician's posture and movement during an instrumental forceps delivery

Manon Sorel; Laetitia Fradet; Perrine Coste-Mazeau; Yves Aubard; Anne-Cécile Pizzoferrato; Fabrice Pierre; Bertrand Gachon

doi:10.1016/j.jogoh.2023.102654

A new approach to assessing the obstetrician's posture and movement during an instrumental forceps delivery

J Gynecol Obstet Hum Reprod. 2023 Nov;52(9):102654. doi: 10.1016/j.jogoh.2023.102654. Epub 2023 Aug 27.

Authors

Manon Sorel¹, Laetitia Fradet², Perrine Coste-Mazeau³, Yves Aubard³, Anne-Cécile Pizzoferrato⁴, Fabrice Pierre⁵, Bertrand Gachon⁶

Affiliations

¹ Department of Obstetrics and Gynecology, University Hospital Center of Poitiers, 2 rue de la Milétrie, CS 90577, 86021 Poitiers Cedex, France. Electronic address: sorelmanon35@gmail.com.
² Pprime Institute UPR 3346-CNRS, Axe RoBioSS, University of Poitiers, 2 Boulevard des Frères Lumière 86360 Chasseneuil-du-Poitou, France.
³ Department of Obstetrics and Gynecology, University Hospital Center of Limoges, 2 Avenue Martin Luther King 87000 Limoges, France.
⁴ Department of Obstetrics and Gynecology, University Hospital Center of Poitiers, 2 rue de la Milétrie, CS 90577, 86021 Poitiers Cedex, France; Clinical investigation center, INSERM CIC 1402, Entrée 5 - Cours Est Jean Bernard CHU de Poitiers 2 rue de la Milétrie 86000 Poitiers, France.
⁵ Department of Obstetrics and Gynecology, University Hospital Center of Poitiers, 2 rue de la Milétrie, CS 90577, 86021 Poitiers Cedex, France.
⁶ Department of Obstetrics and Gynecology, University Hospital Center of Poitiers, 2 rue de la Milétrie, CS 90577, 86021 Poitiers Cedex, France; Clinical investigation center, INSERM CIC 1402, Entrée 5 - Cours Est Jean Bernard CHU de Poitiers 2 rue de la Milétrie 86000 Poitiers, France; Motricité Interaction Performance, EA 4334, University of Nantes, 23 rue du Recteur Schmitt Bâtiment F0 - BP 92235 44322 Nantes France.

PMID: 37643694
DOI: 10.1016/j.jogoh.2023.102654

Abstract

Introduction: The number of deliveries by forceps decreases significantly in favour of the vacuum. Now, when the use of forceps is necessary, physicians less experimented with this procedure are likely to induce serious and preventable perineal or foetal injuries. Training therefore becomes essential. However, there are no clear recommendations on the technique to perform a delivery by forceps, namely the body posture and gesture to adopt. Our goal is then to provide a protocol that can help to determine if there is an optimal technique to perform a delivery by forceps.

Method: We will include voluntary participants whose level of experience and type of practice differ. We will propose to record their postures and gestures using an optoelectronic motion analysis system during a forceps delivery simulated on a mannequin. We will also measure the traction force produced by the subject on the forceps using force platforms and technical markers placed on the forceps. We will then perform a principal component analysis to look for similar motion patterns.

Expected results: We plan to analyse about fifty participants (25 seniors and 25 juniors). Our hypothesis is that the realism of the simulation will be deemed satisfactory by the participants, that the experimental conditions will not modify their gestures, and that the degree of experience will result in different techniques.

Conclusion: A better knowledge on the posture and gesture to adopt to realise a forceps delivery should improve the safety of women and new-borns. The results of this study could also be a valuable contribution for the training of obstetricians.

Keywords: Forceps delivery; Motion capture; Obstetrical biomechanics; Traction forces; Training simulation.

MeSH terms

Delivery, Obstetric
Extraction, Obstetrical*
Female
Humans
Obstetrical Forceps*
Obstetricians
Posture
Pregnancy