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Updated: Sep 8, 2025

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Internal podalic version of second twin: Improving feet identification using a simulation model.

David Desseauve1, Caroline Daelemans2, Alexandre Farin3

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Summary

This study introduces a 3D-printed model for training fetal extremity identification during simulated breech births. The model significantly improved trainees' speed and success in simulated podalic version and breech extraction procedures.

Keywords:
3D printingsSimulationTechnical skillsTwins

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Area of Science:

  • Obstetrics and Gynecology
  • Medical Simulation
  • 3D Printing in Medicine

Background:

  • Podalic version and breech extraction demand advanced obstetrical skills.
  • Accurate identification of fetal extremities is critical for trainees.
  • Inadequate skill in fetal extremity identification can prolong delivery intervals and complicate procedures.

Purpose of the Study:

  • To develop and evaluate a novel simulation model for training fetal extremity identification.
  • To improve trainee proficiency in skills required for podalic version and breech extraction.

Main Methods:

  • A simulation model was created using a birth mannequin and 3D-printed fetal hands and feet.
  • 3D models of fetal extremities were created from ultrasound data.
  • Hands and feet were placed in water-filled condoms within a pelvic mannequin for tactile simulation.
  • Trainee performance was assessed before and after using the simulation model.

Main Results:

  • A significant reduction in the mean time to extract the first foot and all feet was observed.
  • The simulation model effectively trained and assessed the targeted obstetrical skill.

Conclusions:

  • The developed 3D-printed model provides a viable training and assessment tool.
  • This method enhances a critical skill for performing safe and efficient version and breech extraction procedures.