Giving birth vaginally still involves, in the 21ste century, risks for the mother and the unborn child, especially when the fetus is not correctly placed in the uterus. But this risk is unevenly distributed across the planet. While 98% of stillbirths worldwide are recorded in low- and middle-income countries, a team of multidisciplinary researchers (engineers and clinicians), at the Weiss center at University College London, has come up with an innovative glove. to reduce the risk of new mortality: connected to a smartphone, the glove is designed to allow future midwives to train on a prototype fetal head and to differentiate between the back and the front of the skull by simple touch, depending in particular on the position of the fontanelles and the sutures of the skull represented by flexible zones. This project, the connected part of which was designed to be accessible to as many countries as possible, is described in the review Frontiers in Global Women’s Health of January 30.
“Obstetrics is the perfect specialty for this glove, as internal vaginal examination is subjective and can be subject to error”explains obstetrician and gynecologist Shireen Jaufuraully, lead author of the publication. “We need to know which way the baby is facing so that we can safely place instruments on him if help is needed to deliver him. »
The project, at the stage of preliminary prototype », required more than two years of research and must now be “improved by multiple iterations”, continues Shireen Jaufuraully. “In the next few months, we will carry out a laboratory study where we will invite obstetricians of different levels to test the glove on the head models. After the resulting improvements, we hope to be able to perform a first-in-man study at University College Hospital, London. » The practitioner specifies that the objective, in the longer term, “is that this approach be universalized, in order to improve safety and training in operative childbirth”.
The sociologist at the Institute of Research for Development (IRD) Clémence Schantz, also a midwife, believes at first glance that we should not minimize “the real clinical knowledge related to touch that exists, for example, in many African countries” . She herself, she says, was able to benefit from it when she arrived in Burkina Faso in 2004, when she had to “relearning to work when there was almost no technology to hear, for example, the heartbeat of the fetus”. However, this knowledgeable observer recognizes that in low-income countries there is a problem of multifactorial neonatal mortality, in particular due to a lack of training. If this prototype develops and becomes a tool, she believes, “it could allow students to acquire a basic or a minimum of clinical knowledge before moving on to vaginal exams on parturients [femmes sur le point d’accoucher] ».