Abstract
Bandl’s ring is a rare pathology, although its incidence is thought to be rising. Training curricula for treating this condition is almost nonexistent. Patients who present with this disease require specific management and treatment. Practicing these techniques in a medical simulation lab allows trainees to hone their skills in a safe, inconsequential environment. We present a simulated case in which a patient presents with a Bandl’s ring.
Highlights
Bandl’s ring, known as a pathological uterine ring, is a constriction between a woman’s thickened upper contractile uterine segment and thinned lower uterine segment (LUS) during parturition [1, 2]
We present a simulated case in which a patient presents with a Bandl’s ring
As Bandl's ring is associated with an infant mortality rate greater than 50% [3], it is paramount that proper instruction is given to healthcare providers regarding treating both the mother and child
Summary
Bandl’s ring, known as a pathological uterine ring, is a constriction between a woman’s thickened upper contractile uterine segment and thinned lower uterine segment (LUS) during parturition [1, 2]. The uterine muscle creates a band in which the baby’s head or shoulders remains trapped, leading to inability to deliver the infant through the uterine incision This constriction may result in severe trauma to the infant’s head, neck, or shoulders leading to delayed developmental milestones and cerebral palsy [3]. It is unclear what causes Bandl’s ring. One difficulty in providing adequate training for residents in treating Bandl’s ring is a low prevalence rate. The Bandl’s ring scenario is run in a simulation lab made to replicate a typical obstetrics facility. This allows for the delivering provider to make the decision to either attempt vaginal delivery or proceed to a cesarean. From left to right: 1) Dragon Skin part A, 2) Mann Mold Release, 3) Dragon Skin part B, 4) Cardboard, 5) Vials, 6) Stapler, 7) Anti-embolism sock, 8) Mixing bowl, 9) Rubber adhesive, 10) Silc Pig Red, 11) Scalpel, 12) Binder clips, 13) Scissors, 14) Toothbrush, 15) Plastic spoons, 16) Tongue depressors, 17) Ruler, 18) Velcro, 19) Pelvic accessory, 20) Suture kit
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