Obstetric Technology Research Articles

Simulation Technologies in Obstetrics: Teaching in a New Way or Leaving the Status Quo?

The protection of reproductive health of the population of Russia has been declared by the country's leadership to be the most important state task and is one of the priority components of the National Projects "Healthcare", "Demography" and "Family". The development of the latest technologies in medicine determines the need to create and widely implement an innovative approach to the training and professional preparation of doctors. In this regard, there is a need to change the methodology for training doctors at present.

Study on the clinical value of the wearable foetal electrocardiogram monitoring system.

Electronic foetal monitoring (EFM), a method to monitor foetal intrauterine conditions and foetal reserve capacity, is the most extensively used intrauterine monitoring technology in obstetrics. This study aims to compare the Thoth wearable foetal electrocardiogram (foetal ECG [FECG]) monitoring system with a traditional Doppler foetal heart monitoring system before labour to investigate their respective values in clinical application. A total of 393 pregnant women admitted to our hospital between 2020 and 2022 participated in this study. They were recruited using the convenience sampling method. We employed a paired design to assess the confusion rate, trend overlap, and foetal heart rate/ECG monitoring consistency, whereas a completely randomised design was used to measure pregnancy outcome indicators. The participants were divided into two groups using a random number table: the Thoth group (n= 196) and the traditional Doppler group (n= 197). Each group was monitored using the corresponding system. The Thoth monitor demonstrated a lower confusion rate compared with the traditional Doppler monitor (0.25% vs 2.04%; χ2= 5.508, P= 0.019). The trend overlap in foetal heart rates was consistently 100%, with 91.2% of readings showing a consistency rate of ⩾ 95%. Additionally, the Thoth monitor recorded a higher cumulative interruption time in the foetal heart rate curve (12.13 ± 2.22 vs 21.02 ± 2.34; t= 18.471, P< 0.001) and more abnormal ECGs (21.21 ± 4.32 vs 18.21 ± 2.91; t= 7.582, P< 0.001) than the traditional Doppler system. The Thoth wearable FECG monitor offers several advantages over the traditional Doppler foetal heart monitoring system. These include a reduced confusion rate, more accurate data collection, a lower rate of clinical misjudgement, reduced workload for medical staff, and enhanced comfort during vaginal delivery. The rates of emergency caesarean sections and neonatal asphyxia in the Thoth group were marginally lower than those in the Doppler group, which may be attributed to issues such as ECG disconnection or interference from the maternal heart rate.

Exploring the Evolution of Robotic Surgery in Obstetrics and Gynecology: Past, Present, and Future Perspectives.

Robotic surgery has emerged as a transformative technology in obstetrics and gynecology, offering enhanced precision and minimally invasive techniques for various procedures. This paper explores the evolution of robotic surgery in obstetrics and gynecology, examining its historical development, current applications, and prospects. Through a comprehensive review of the literature and case studies, we highlight the benefits of robotic surgery, including reduced trauma, improved patient outcomes, and increased surgeon capabilities. However, cost, training requirements, and regulatory concerns hinder widespread adoption. Continuing technological innovation is expected to enhance the efficacy and applicability of robotic-assisted procedures. Collaboration between healthcare professionals, researchers, and industry stakeholders is essential to address these challenges and ensure optimal patient care. By embracing the opportunities presented by robotic surgery while addressing associated challenges, practitioners and researchers can contribute to the continued advancement of this transformative technology in obstetrics and gynecology.

Analysis of the Application Effect of Painless Delivery Technology in Clinical Obstetrics

Objective: To explore the application effect of painless delivery technology in clinical obstetrics. Methods: Clinical data of 900 women who gave birth were collected and randomly divided into groups A and B, each comprising 450 cases. Group A served as the control group, while Group B acted as the observation group. Group A underwent natural delivery, whereas Group B received combined spinal-epidural anesthesia for painless delivery. The effects of these two delivery techniques were comprehensively evaluated based on maternal pain level, postpartum recovery, postpartum lactation, and other relevant indicators. Results: In Group B, there were more individuals with pain levels of 0 and 1 compared to Group A, and significantly fewer individuals with pain levels of 2 and 3 than in Group A (P &lt; 0.05). This suggests that the pain level in Group B was significantly superior to that in Group A. Additionally, postpartum recovery indicators among mothers in Group A were significantly higher than those in Group B (P &lt; 0.05). Furthermore, the time for the onset of colostrum mobilization and adequate breast milk production was significantly longer in Group A compared to Group B (P &lt; 0.05). Conclusion: Combined spinal-epidural anesthesia with ropivacaine + sufentanil demonstrates a positive application effect in painless delivery.

Research and Discussion on the Application of Virtual Simulation Technology in Obstetrics and Gynecology Teaching

Research and Discussion on the Application of Virtual Simulation Technology in Obstetrics and Gynecology Teaching

Использование телемедицинских технологий для оказания медицинской помощи беременным с факторами риска преждевременных родов.

Introduction. Telemedicine technologies are increasingly being used in various areas of medicine to manage patients with various nosologies. Obstetrics is no exception, in particular the use of telemedicine technologies in the management of pregnant women with risk factors for preterm birth. To study the world experience, a search was carried out in Russian and international databases. Relevant articles were selected for detailed study. The purpose of the study – to search for publications on the use of telemedicine technologies in obstetric practice for the management of pregnant women with risk factors for preterm birth, to analyze and systematize, and on the base of the expe- rience presented in the articles, to determine the acceptability, problems and prospects for the development of tele-obstetrics for the management of pregnant women with risk factors for preterm birth. Materials and methods. A search was carried out in the international electronic database PubMed and the Russian electronic libraries CyberLeninka, eLIBRARY.RU. Results. For the five-year period under review, from 2017 to 2021 with the help of electronic libraries, 15 relevant full-text articles were selected for detailed study. The analysis of the articles showed that 46.6% of scientific papers are devoted to de- scription of the experience of using telemedicine technologies in assisting pregnant women, 33.3% describe the introduction of telemedicine applications, and 13.3% are devoted to the use of telemonitoring. 33.3% of the selected articles reflect the ef- fectiveness of using automated pregnancy monitoring systems, 6.7% of the articles consider the methodology for creating databases, 6,7% give the legislative framework for integrating telemedicine into the obstetric service, and 6,7% are reviews. Conclusion. The use of telemedicine technologies in obstetrics has good prospects, as it improves the availability, quality and safety of medical care, and reduces the psycho-emotional stress experienced by pregnant women during hospitalization.

New Technologies in Obstetrics and Gynecology: Presentations

New Technologies in Obstetrics and Gynecology, University of Iowa Obstetrics and Gynecology Postgraduate Conference, Hyatt Regency Coralville, Coralville, IA. November 4, 2022 Presentations

New Technologies in Obstetrics and Gynecology: Poster Presentations

New Technologies in Obstetrics and Gynecology, University of Iowa Obstetrics and Gynecology Postgraduate Conference, Hyatt Regency Coralville, Coralville, IA. November 4, 2022Poster Presentations

Introduction to Machine Learning in Obstetrics and Gynecology.

In the digital age of the 21st century, we have witnessed an explosion in data matched by remarkable progress in the field of computer science and engineering, with the development of powerful and portable artificial intelligence-powered technologies. At the same time, global connectivity powered by mobile technology has led to an increasing number of connected users and connected devices. In just the past 5 years, the convergence of these technologies in obstetrics and gynecology has resulted in the development of innovative artificial intelligence-powered digital health devices that allow easy and accurate patient risk stratification for an array of conditions spanning early pregnancy, labor and delivery, and care of the newborn. Yet, breakthroughs in artificial intelligence and other new and emerging technologies currently have a slow adoption rate in medicine, despite the availability of large data sets that include individual electronic health records spanning years of care, genomics, and the microbiome. As a result, patient interactions with health care remain burdened by antiquated processes that are inefficient and inconvenient. A few health care institutions have recognized these gaps and, with an influx of venture capital investments, are now making in-roads in medical practice with digital products driven by artificial intelligence algorithms. In this article, we trace the history, applications, and ethical challenges of the artificial intelligence that will be at the forefront of digitally transforming obstetrics and gynecology and medical practice in general.

Closest and long-term prospects of 3D-printing for obstetrics and gynecology

Introduction. Despite the notable and rapid progress in the development of medical 3D printing in recent years, not much is known about the use of this technology in obstetrics and gynecology.The purpose of our review of scientific literature was to determine the current level of 3D printing development, discuss the closest and long term prospects for using this technology in obstetrics and gynecology, and analyze its potential advantages and disadvantages.Materials and methods. We searched for scientific literature. 378 papers passed a three-step screening, as a result of which 42 sources were selected for the final scientific review.Results and discussion. The main areas in which dimensional printing can be used in this area of medicine is the creation of simulation models and training for students, the creation of anatomical models for preoperative preparation, the surgical instruments, the creation of new dosage drug forms (including transvaginal ones), and bioprinting of organs and tissues.Conclusion. The presented literary review allows us to conclude that 3D printing the obstetrics and gynecology is a current rapidly developing direction. The organization of 3D modeling and printing laboratories can significantly increase the efficiency of teaching students and residents. In addition, obstetricians-gynecologists and surgeons should be informed about the possibility of 3D printing surgical instruments according to an individual design. It can inspire them to implement their own ideas and develop domestic innovative developments. Three-dimensional printing of dosage forms and bioprostheses requires more complex technological solutions, and is not yet used in clinical practice. However, given the enormous prospects for these areas, various grants should be envisaged for their development in Russia

Applications of Advanced Ultrasound Technology in Obstetrics.

Over the years, there have been several improvements in ultrasound technologies including high-resolution ultrasonography, linear transducer, radiant flow, three-/four-dimensional (3D/4D) ultrasound, speckle tracking of the fetal heart, and artificial intelligence. The aims of this review are to evaluate the use of these advanced technologies in obstetrics in the midst of new guidelines on and new techniques of obstetric ultrasonography. In particular, whether these technologies can improve the diagnostic capability, functional analysis, workflow, and ergonomics of obstetric ultrasound examinations will be discussed.

Будущее наступило. Обзор мировых инновационных технологий в акушерстве и гинекологии

Medical science does not stand still. Obstetrics and gynecology are dynamically developing disciplines, constantly updated with the latest achievements of medical science and practice. The article provides an overview of modern innovative technologies in obstetrics, gynecology, perinatology, reproductive medicine and medical genetics in Russia and in the world.

Use of Telemedicine and Smart Technology in Obstetrics: Barriers and Privacy Issues.

While telemedicine had been utilized in varying ways over the last several years, it has dramatically accelerated in the era of the COVID-19 pandemic. In this article we describe the privacy issues, in relation to the barriers to care for health care providers and barriers to the obstetric patient, licensing and payments for telehealth services, technological issues and language barriers. While there may be barriers to the use of telehealth services this type of care is feasible and the barriers are surmountable.

Conceptual Framework for Implementing the Saudi Childbirth Initiative

There are many efforts internationally to achieve safe and respectful Mother-Baby–Family maternity care. This article is the first to provide a conceptual framework for implementing the Saudi Childbirth Initiative (SCI) in all health institutions in Saudi Arabia. It introduces the 10 Steps of the SCI to strategically achieve a safe and respectful Mother-Baby–Family maternity care in order to improve maternal and infant outcome and implement evidence-based maternity care in Saudi Arabia. The SCI is developed upon previous initiatives and integrates and supports much of the current work being carried out by many organizations. The aim of the SCI's 10 Steps is to improve care throughout the childbearing continuum, to save lives, prevent illness and harm from the overuse of obstetric technologies, and promote health for mothers and babies and to provide clear guidelines for providing optimal maternity care. Safe and respectful Mother-Baby–Family Maternity Care is measurable and for each of the 10 Steps, there is an associated assessment tool to ensure these guidelines are being established by health institutions. SCI envisions that successful implementation of the 10 Steps can be measured and monitored using the a combination of statistical information and key performance indicators (KPIs) to measure maternal mortality and morbidity outcomes (currently in development) using local assessors.

Diagnosis of Interventional Transvaginal Maternal Diseases Based on Color Doppler Ultrasound.

In recent years, with the development of color Doppler ultrasound technology in obstetrics, this noninvasive, direct, convenient, and sensitive inspection method has become one of the best methods to observe the fetal circulation in the uterus. This paper discusses the clinical value of using transvaginal color Doppler ultrasound in the differential diagnosis of ovarian corpus luteum disease and ectopic pregnancy disease. This paper selects 100 cases of ectopic pregnancy and 100 cases of pregnant corpus luteum as the experimental research objects. Clinical analysis of transvaginal color Doppler ultrasonography was performed on all patients. In the process of measuring the patient's ectopic pregnancy, the size of the patient's adnexal mass is mainly measured, and the blood flow spectrum is measured. The clinical choice of transvaginal color Doppler ultrasound method to distinguish ectopic pregnancy disease and corpus luteum pregnancy disease can play a significant value. It can be effectively diagnosed according to the type of disease, then effective methods can be studied for clinical treatment, the quality of life of patients with the two diseases can be significantly improved, and the clinical application value of color Doppler ultrasound can be improved.

Nanoparticles in pregnancy: the next frontier in reproductive therapeutics.

Nanotechnology involves the engineering of structures on a molecular level. Nanomedicine and nano-delivery systems have been designed to deliver therapeutic agents to a target site or organ in a controlled manner, maximizing efficacy while minimizing off-target effects of the therapeutic agent administered. In both reproductive medicine and obstetrics, developing innovative therapeutics is often tempered by fears of damage to the gamete, embryo or developing foetus or of negatively impacting a woman's reproductive potential. Thus, nanomedicine delivery systems may provide alternative targeted intervention strategies, treating the source of the disease and minimizing long-term consequences for the mother and/or her foetus. This review summarizes the current state of nanomedicine technology in reproductive medicine and obstetrics, including safety, potential applications, future directions and the hurdles for translation. A comprehensive electronic literature search of PubMed and Web of Science databases was performed to identify studies published in English up until February 2020. Relevant keywords were used to obtain information regarding use of nanoparticle technology in fertility and gene therapy, early pregnancy complications (ectopic pregnancy and gestational trophoblastic disease) and obstetric complications (preeclampsia, foetal growth restriction, preterm birth and gestational diabetes) and for selective treatment of the mother or foetus. Safety of specific nanoparticles to the gamete, embryo and foetus was also investigated. Pre-clinical research in the development of nanoparticle therapeutic delivery is being undertaken in many fields of reproductive medicine. Non-hormonal-targeted nanoparticle therapy for fibroids and endometriosis may provide fertility-sparing medical management. Delivery of interventions via nanotechnology provides opportunities for gene manipulation and delivery in mammalian gametes. Targeting cytotoxic treatments to early pregnancy tissue provides an alternative approach to manage ectopic pregnancies and gestational trophoblastic disease. In pregnancy, nanotherapeutic delivery offers options to stably deliver silencing RNA and microRNA inhibitors to the placenta to regulate gene expression, opening doors to novel genetic treatments for preeclampsia and foetal growth restriction. Restricting delivery of teratogenic drugs to the maternal compartment (such as warfarin) may reduce risks to the foetus. Alternatively, targeted delivery of drugs to the foetus (such as those to treat foetal arrythmias) may minimize side effects for the mother. We expect that further development of targeted therapies using nanoparticles in a reproductive setting has promise to eventually allow safe and directed treatments for conditions impacting the health and reproductive capacity of women and for the management of pregnancy and serious pregnancy complications.

'A caesarean section is like you've never delivered a baby': A mixed methods study of the experience of childbirth among French women.

The experience of childbirth has been technologized worldwide, leading to major social changes. In France, childbirth occurs almost exclusively in hospitals. Few studies have been published on the opinions of French women regarding obstetric technology and, in particular, caesarean section. In 2017–2018, we used a mixed methods approach to determine French women’s preferences regarding the mode of delivery, and captured their experiences and satisfaction in relation to childbirth in two maternity settings. Of 284 pregnant women, 277 (97.5%) expressed a preference for vaginal birth, while seven (2.5%) women expressed a preference for caesarean section. Vaginal birth was also preferred among 26 women who underwent an in-depth interview. Vaginal birth was perceived as more natural, less risky and less painful, and to favour mother–child bonding. This vision was shared by caregivers. The women who expressed a preference for vaginal birth tended to remain sexually active late in their pregnancy, to find sexual intercourse pleasurable, and to believe that vaginal birth would not enlarge their vagina. A large majority (94.5%) of women who gave birth vaginally were satisfied with their childbirth experience, compared with 24.3% of those who underwent caesarean section. The caring attitude of the caregivers contributed to increasing this satisfaction. The notion of women’s ‘empowerment’ emerged spontaneously in women’s discourse in this research: women who gave birth vaginally felt satisfied and empowered. The vision shared by caregivers and women that vaginal birth is a natural process contributes to the stability of caesarean section rates in France.

Advances of magnetic surgery in the field of urology, obstetrics, and gynecology

Currently, magnetic devices have been widely used in the fields of production and daily living, including surgical practice. By generating attractive or repulsive force without direct contact, magnetic materials have shown high superiority in simplifying the process of diagnosis and treatment, developing novel medical instruments, reducing postoperative complications, and overcoming drawbacks of traditional operations. Especially in the diagnosis and treatment of gastrointestinal and hepatobiliary surgery, the clinical application of magnetic surgery has developed rapidly and is becoming increasingly mature. With the wide use of magnets in clinical practice, the discipline of magnetic surgery has been developed in recent years. After further innovation and continuous development, a magnetic system for clinical application is produced and contains five parts: Magnetic compression technique, magnetic anchor technique, magnetic navigation technique, magnetic levitation technique, and magnetic tracer technique. In the field of urology, obstetrics, and gynecology, researchers have constantly absorbed and integrated the advantages of magnetic compression technique, magnetic anchor technique, and magnetic navigation technique to explore more minimally invasive, more accurate, simpler, and safer operations. Magnetic devices have been used in clinical practice effectively to develop new diagnosis and treatment methods. However, the application range of magnetic technology in urology, obstetrics, and gynecology is limited; fundamental and clinical research is scattered; and the development process is slow. There is still no breakthrough in magnetic levitation and magnetic tracer technique. Therefore, combined with the current content of magnetic surgery, this article briefly describes the development status of magnetic surgery technology and summarizes fundamental research or clinical examples of magnetic technique application in urology, obstetrics, and gynecology. It consists of three parts: Introduction of the content of magnetic surgery system, demonstration of application in urology, obstetrics, and gynecology, and discussion on future prospects. In general, the use of magnetic technology in the field of urology starts relatively early, but the development is slow; the interaction between magnetic technology and obstetrics and gynecology starts late, but the depth and breadth are rapidly expanding. Magnetic technology makes diagnosis and treatment more minimally invasive, more efficient, and safer. Although magnetic levitation and magnetic tracer techniques are rarely used in the field of urology, obstetrics, and gynecology, it is believed that with the advancement of biomaterial science combined with modern surgery, especially the combination of medicine and engineering, magnetic surgery will have a broader effect. Rapid development of magnetic surgery will be achieved, and its richer application will be beneficial to human health. This paper is aimed at introducing advances of magnetic surgery in the field of urology, obstetrics, and gynecology in recent years, providing references and directions for clinical innovation in future research. At the same time, summarizing the current research advances of the discipline is beneficial for further interdisciplinary integration and the mutual promotion between the magnetic surgery system and the field of urology, obstetrics, and gynecology.

Major obstetric haemorrhage: portrait of "near miss" and risk management-based optimisation of obstetric techniques and telemedicine technologies

Aim. To identify measures for the improvement of obstetric techniques and telemedicine technologies in women with major obstetric haemorrhage.Materials and Methods. We analyzed medical documentation of 54 women in Altai Krai who experienced major obstetric haemorrhage within 28- 36 weeks of gestation before (2008-2012) and after (2013-2017) implementation of risk management using the telemedicine “Registry of pregnancies” technology.Results. Implementation of risk management principles led to the admission of women with major obstetric haemorrhage exclusively to specialised hospitals in contrast to the preceding period. Further, it was associated with a higher prevalence of caesarean sections (from 55.6% to 96.3%) in women with major obstetric haemorrhage due to an increase in cases of complete placenta previa or placenta increta. In 73.0% of cases, such patients delivered in specialised hospitals where autologous blood transfusion or intrauterine balloon tamponade could be applied. In spite of increase in frequency of major obstetric haemorrhages, risk management reduced their severity by decreasing blood loss and, hence, the risk of posthaemorrhagic complications and blood transfusion side effects.Conclusions. Risk management-based strategy for optimising obstetric care by telemedicine technologies leads to the admission of high-risk, even “near miss” patients in specialised hospitals that is particularly efficient in regions with low population density and a large network of primary healthcare facilities.

Narratives of responsibility: Maternal mortality, reproductive governance, and midwifery in Mexico.

This research highlights the malleability of Maternal Mortality Ratios (MMR) and the ways in which they accommodate a variety of narratives via their claims about women's access to reproductive health services. MMR plays an important role in determining fiscal and legislative priorities for women's health in Mexico and in the discursive practices that shape societal beliefs about appropriate birthing practices and birth attendants. This paper is based on ethnographic fieldwork conducted in Yucatán and Quintana Roo between 2009 and 2017 during Ministry of Health midwifery workshops and approximately fifty interviews with midwives, doctors, public health officials, and parents. It explores the mutability of MMR within the context of political struggles for midwifery in Mexico-both for and against its legality and existence. In Mexico, MMR is often used by bureaucrats and public health workers to reinforce the importance of biomedical obstetric services over midwifery. However, the same metrics are also employed by midwives in critiques of underfunded and often structurally-violent maternal health care services. While doctors attempt to use MMR to prove that birth is inherently dangerous and must take place in hospitals with access to obstetric technologies and interventions, midwives use MMR to demonstrate that birth in hospitals is risky precisely because of those technologies and their inappropriate use, and to draw international attention and funding in support of midwifery. In addition to examining the strategic use of MMR in health-related discourses, this paper interrogates techniques employed by the state to limit midwives' access to births in the name of monitoring and improving MMR. I contend that while discursive uses of MMR to advance professional and political goals are common in both midwifery and biomedicine, the asymmetric power relations of biomedicine vis-à-vis the Mexican state privilege interpretations of MMR that justify and legitimate enhanced bureaucratic surveillance of midwives.