Emergency caesarean simulator helps train doctors

Emergency caesarean simulator Emergency caesarean: a desperate situation for mother and baby

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An emergency caesarean simulator has been launched by the NHS to help train doctors to perform complex C-sections.

Guy's and St Thomas' NHS Foundation Trust is the first to use the model, nicknamed Desperate Debra.

The "pregnant" abdomen, made from silicone and plastic, mimics advanced labour - where the baby's head gets stuck in the mother's pelvis.

This affects around 15 births a day in the UK and can be life-threatening to mother and baby.

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It teaches the paradox between brute force to get the baby out, and a gentle touch as to not cause any damage to the soft tissues”

End Quote Andrew Shennan Prof of obstetrics at Guys' and St Thomas' NHS Foundation Trust

The model simulates how a stuck baby, needs to be pushed back into the uterus, before being removed through an incision in the abdomen.

"Emergency caesareans at full dilation can be challenging and dangerous," said Andrew Shennan, a professor of obstetrics.

He said this tended to be a problem at night "when doctors with experience of this situation may not be available".

"Using Desperate Debra to help train doctors in this scenario should reduce the likelihood of serious complications for the infant and mother."

Scary and difficult

Desperate Debra's name reflects the potential seriousness of such situations.

"You are caught between the devil and the deep blue sea," said Prof Shennan. "You can't get the baby out normally, the mother is exhausted - it is a scary and difficult situation. An emergency caesarean is the best thing to do."

Initially designed by Dr Graham Tydeman, a consultant in obstetrics and gynaecology at NHS Fife, simulator experts fine-tuned it to develop how it felt, the forces involved and the conditions.

Prof Shennan said: "It is amazingly realistic - exactly what it feels like.

"It teaches the paradox between brute force to get the baby out, and a gentle touch as to not cause any damage to the soft tissues."

To help achieve this, the manufacturers visited a maternity ward to learn about a baby's head and its soft areas, where the bones have yet to fuse - the fontanelles.

"To get the right feel we experimented with a number of materials," said Gabriel Ogwo, from manufacturers Adam, Rouilly.

"Desperate Debra is made with highly engineered plastic and silicone - metal had to be kept to a minimum to avoid corrosion from the synthetic blood and lubricant that is used in training."

Other birth simulators help train doctors to use forceps, and a model baby helps junior doctors spot and deal with a seriously ill baby.

Prof Shennan said: "There are other teaching models a bit like it, but certainly nothing that mimics the difficulty of getting a head out during a caesarean."

The model is now ready for mass production.

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