Metrics of perineal support (MOPS) study

Area of Science:

• Obstetrics and Gynecology
• Biomedical Engineering
• Clinical Biomechanics

Background:

• Manual perineal protection (MPP) is an intrapartum technique to preserve perineal integrity during childbirth.
• Evaluating MPP's effectiveness is challenging due to numerous confounding obstetric variables.
• Quantifying the forces and timing of MPP is crucial for understanding its mechanics.

Purpose of the Study:

• To measure the forces exerted by the accoucheur's fingers and thumb during MPP.
• To quantify the duration of MPP during fetal head expulsion.
• To investigate the temporal coordination of finger and thumb actions during MPP.

Main Methods:

• Developed and utilized bespoke measurement gloves (MG) with integrated sensors to record applied forces in real-time.
• Data was wirelessly transmitted to a computer system for analysis.
• A prospective pilot study enrolled 20 women undergoing their first vaginal birth, with deliveries attended by experienced obstetricians.

Main Results:

• The mean duration of MPP application during the final contraction was 13.6 seconds, with 20% lasting less than 5 seconds.
• Mean forces exerted by the thumb, index, and middle fingers ranged from 20.2 N to 34.3 N.
• Simultaneous initiation of thumb and finger activity occurred in 65% of cases.

Conclusions:

• MPP is a brief intervention during fetal head expulsion, with simultaneous hand component activation in most instances.
• Variations in force application and duration were observed between practitioners, notably in thumb forces.
• Findings provide foundational data for refining computational models of MPP to optimize obstetric techniques.