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05/12/2018

A midwife at Vall d'Hebron designs a cushion for pregnant women that corrects the incorrect position of the fetus in childbirth

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05/12/2018

In some parts the fetus is placed in the maternal pelvis facing up, hindering the exit of the fetus and increasing the risk of a cesarean section. The cushion helps the fetus to turn around, thus facilitating vaginal delivery.

A midwife at Vall d'Hebron, Vanessa Bueno, has designed a postural cushion for pregnant women that corrects the malposition of the fetal head during labor and which also facilitates women's rest during the third trimester of pregnancy.At the time of delivery, the fetus needs to face head down. But, in about 40% of women, the fetus is facing up. If this incorrect position is not corrected, it is necessary to perform a caesarean section or use forceps. As Vanessa Bueno explains, "this postural cushion is designed in such a way that women, lying sideways, place it between her legs to open the pelvis diameter and cause the internal rotation of her upper leg's knee. Thus, the pillow helps to rotate the fetus head downwards as it finds more space in the pelvis allowing the delivery to be vaginal ".The origin of this idea is found in a clinical trial carried out by Vanessa Bueno on how to facilitate the rotation of the fetus during childbirth when a malposition occurs. The ideal position to achieve this is the modified Sims position, with the woman placed in a lateral decubitus position (lying on the side) with her upper leg parallel to her lower leg and her knee rotated inwardly. "To assess the effects of this position during delivery --explains Vanessa Bueno--, we carried out a study using the stretcher's leg holders in order to raise her leg with the woman on the side. The results showed that there were more vaginal deliveries, cesarean sections were reduced by 16%, and maternal and fetal morbidity was reduced, as well as hospital stay and subsequent emergency visits, because there were fewer complications" The results of this study have been published in the https://onlinelibrary.wiley.com/doi/abs/10.1111/birt.12347 Birth journal.Women felt satisfied with the labor done in this position. But, if it takes longer, using leg holders reduces comfort. "Therefore, I designed a postural cushion that made the same position possible" adds Vanessa Bueno, "since there is no cushion of this type for this purpose. Thus, it can be used by any woman regardless of the hospital bed and we make sure that the position, the opening angle of the pelvis and the rotation of her upper leg's knee are always adequate and the woman is comfortable".Therefore, the use of this cushion during the dilation hours facilitates the proper orientation of the fetus and can reduce the risk of a cesarean section. "Similarly, knowing the correct orientation of the fetus is very useful because, as it causes the pelvic opening, there is more room for the fetus to come out" adds Vanessa Bueno.Better rest during the third trimester in pregnant womenApart from its use in facilitating vaginal delivery, this cushion also helps pregnant women improve their rest during the third trimester of gestation. "The resting position that is recommended to pregnant women in order to improve the oxygenation of the fetus and reduce maternal pressure drops is the lateral decubitus position. Therefore, this cushion is ideal to achieve and maintain this position for many hours, as it prevents lumbar pains and discomfort", indicates Vanessa Bueno.The company Stimulo has also contributed to the design and manufacture of this cushion named Easysims (for the facility to maintain the modified Sims position). Currently, any pregnant woman who needs to improve her labor (either because the fetus is not in the correct position or because her pelvis should be opened more) can use the cushion in Vall d'Hebron.

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