Caesareans are the most commonly performed surgery in the world. Their relative simplicity has halted any research to optimise birthing positions for vaginal delivery. "We’re still using models that go back 150 years,” says David Desseauve, associate physician with the CHUV Gynaecology-Obstetrics Service. "But these days, with progress in computer science, we can now calculate what’s happening inside the uterus using external position measurements." Working with doctoral students in biomechanics from the Swiss BioMotion Lab at CHUV and in imaging from the École polytechnique fédérale de Lausanne (EPFL), the obstetrician wants to use scientific evidence to determine the best positions for the mother when labour is prolonged and could require a C-section.
"We plan to base our research on a typical pelvis of women of childbearing age, determined using scans and MRIs, and which, based on imaging technology similar to morphing, changes shape according to the mother’s characteristics. We can then recalculate the direction of the station of presentation, to get the baby to engage more easily in the pelvis."
The best birthing positions, once catalogued by midwives, will therefore have a scientific basis. Facilitating vaginal delivery should reduce the number of caesareans and complications, such as infections and thromboembolic events, that can arise during the procedure. This research project was one of the winners of the 2019 Leenaards Science Awards.
Source: In Vivo special edition (2019) / Photo: © SAM-CHUV
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