Tags:Delivery-induced damage, gynecology, high-fidelity simulation and pelvic floor
Abstract:
Vaginal delivery is one of the main causes of pelvic floor damages that can lead to a series of short and long-term consequences that clinically fall under the name of pelvic floor dysfunctions. In the last years, the number of women interested by this pathological condition is continuously rising, representing both a medical issue and an important financial burden. Prevention represents the best strategy of care but requires a deep understanding of the injury mechanisms that currently is still missing. High-fidelity simulation proved to be a valid teaching and training tool to improve medical staff competences. Moreover, it can help deepen the study of factors affecting a clinical event, reducing the need of in-vivo analyses. In the specific case of pelvic floor dysfunctions, however, current solutions show a poor replication of the pelvic structures and do not provide any feedback during simulation. These limitations led to the development of an innovative high-fidelity physical simulator as a suitable mean to study the mechanisms behind the pelvic floor damages caused by vaginal delivery. Anatomically faithful muscle, bone, and ligament structures were realized through rapid prototyping and molding techniques using soft materials able to replicate the human tissues behavior. Ad-hoc stretch sensors were realized with resistive fabric and integrated in the pelvic floor to evaluate the tissue elongation caused by fetal head passage. The simulator assessment was carried out both in lab conditions, i.e., through bench tests, and by involving expert gynecologists for a preclinical validation. The obtained results proved the quality of the simulator design. Gynecologists assessed the simulator as a valid teaching and training tool able to provide feedback on the instantaneous pelvic floor elongation, thus any possible induced tissues damage.
Design, Realization and Preliminary Validation of an Active Physical Simulator for the Study of Pelvic Floor Damages During Childbirth