Upper surgical field for cesarean section intervention with neonatal transfer

Abstract

The upper surgical field for cesarean section intervention with neonatal transfer aims to eliminate the current limitations of the "humanized cesarean" by creating a circuit for direct transfer of the newborn to its mother within the surgical field and without altering asepsis. This internal communication is achieved by means of a sterile main drape with a fenestration in its caudal portion that continues perpendicularly with a transfer module located over the maternal thorax, a non-sterile area, with an integrated closure system. Additionally, the main drape has a secondary drape designed to seal the fenestration. This surgical field allows for maintaining sterility during neonatal transfer, optimizes delayed clamping of the umbilical cord, ensures the preservation of heat and continuous visualization of the newborn, achieves immediate skin-to-skin contact, and increases maternal participation in welcoming the newborn.

Description

Upper surgical field for cesarean section intervention with neonatal transfer TECHNICAL SECTOR The present invention belongs to the obstetric surgical sector, specifically for the technical performance of the cesarean section, within the field of medicine. BACKGROUND OF THE INVENTION The term "humanized cesarean" emerged in 2008 with the publication of the article "The natural caesarean: a woman-centered technique," which describes technical modifications to this procedure aimed at aligning the quality of care standards with those of vaginal delivery, provided maternal and perinatal health allows it. These modifications allow for continuous maternal support by a person of the mother's choosing, improving her emotional and personal satisfaction. Secondly, it allows for delayed cord clamping (DCC) after the first minute of life or until the cord stops pulsating, at which point the transition to pulmonary respiration begins. Delaying clamping results in greater blood flow to the newborn (NB), as well as greater hemodynamic stability. Finally, it allows for skin-to-skin contact (SSC) between the NB and its mother.This contact promotes the newborn's cardiopulmonary stability by reducing stress and crying. Additionally, it facilitates the initiation of breastfeeding and mother-newborn bonding. However, the surgical procedure inherent in a "humanized cesarean section" imposes the following secondary limitations to the need to maintain a sterile surgical field, as is the case with any surgical procedure: - The PTCU is not optimal. Until the time to achieve the PTCU is reached, elevating the newborn above the surgical field, in order to maintain asepsis, causes a backflow of blood from the umbilical cord due to gravity, reducing the desired benefit of the PTCU. - Placement of the newborn (PLN) is not immediate. After the procedure, the newborn is routinely handed over to the mother via a route outside the surgical field to prevent contamination. This route is managed by non-sterile healthcare personnel present in the operating room, who receive the newborn from the obstetrician, transfer the baby to the head of the operating table, and assist in positioning the baby on the mother's chest. - Limited maternal participation. EXPLANATION OF THE INVENTION The upper surgical field for performing a "gentle cesarean section" consists of a sterile main drape with a full unfolded dimension of 2400 x 1500 mm, composed of polypropylene and a polyethylene film, giving it absorbent and waterproof properties. The specific elements on the main drape that make up the surgical field for a "gentle cesarean section" are described below in a craniocaudal direction: In its cranial portion, 650 mm from the upper edge, a secondary 500x500 mm cloth of similar composition is attached and rolled up by two Velcro tabs. This will be the new upper surgical drape, which will be unrolled and secured with hypoallergenic adhesive tape once the newborn has passed through the transfer module, thus ensuring the sterility of the surgical field. In its caudal portion, facing the surgical field, 520 mm from the lower edge, there is a 400 mm fenestration that continues perpendicularly with a 400x400 mm transfer module located over the mother's thorax (non-sterile area). This transparent and adaptable module is made of a double layer of polyethylene, allowing for better heat retention, visualization of skin color, and observation of the newborn's respiratory movements during the postpartum uterine transfer (PTCU). Along the entire cranial portion of the transfer module is a zip closure, also made of polyethylene, which, when closed, ensures sterility until the PTCU is completed. Subsequently, opening the zipper by non-sterile medical personnel present in the operating room facilitates the mother's delivery of the newborn. The present invention aims to eliminate the current limitations of "humanized cesarean section" by creating a direct transfer circuit from the newborn to its mother within the surgical field and without altering asepsis. This new circuit improves the obstetric, surgical and care quality of the "humanized cesarean" due to the following advantages: - It eliminates contamination of the surgical field during the presentation of the newborn to the mother after birth. - Ensure adequate immediate CPP. - Ensures adequate PTCU by keeping the newborn in a horizontal position on the mother's chest after birth. - Ensure the newborn's warmth is preserved during PTCU. - Allows visualization of the newborn from birth. - Increases maternal participation in the reception of the newborn. DESCRIPTION OF THE DRAWINGS In order to improve the description presented and to facilitate the understanding of its main characteristics, a set of illustrative and non-limiting figures is included as an integral part of the description; the following has been represented: Figure 1.- Upper surgical field for cesarean section with neonatal transfer. Includes frontal and axial views on the right margin. Craniocaudal orientation. Its main elements are indicated and numbered, with their respective dimensions. The dashed line highlights the elements necessary to ensure correct neonatal transfer. 1. Main cloth 2. Secondary cloth 3. Transfer Module 4. Fenestration Figure 2.- Enlargement of the upper surgical field for cesarean section with neonatal transfer. Pre-neonatal transfer phase. Includes frontal and axial views on the right margin. The introduction of the newborn through the fenestration is evident, with access perpendicular to the interior of the transfer module, which is closed at its cranial end by a zip closure (referenced with number 5), ensuring the sterility of the surgical field during the PTCU. The secondary drape is rolled up. Figure 3.- Enlargement of the upper surgical field for cesarean section with neonatal transfer. Neonatal transfer phase. Includes frontal and axial views on the right margin. The newborn is visible inside the transfer module with the zipper open, allowing its extraction to the mother's chest (non-sterile area). The secondary drape is rolled up. Figure 4.- Enlargement of the upper surgical field for cesarean section with neonatal transfer. Post-neonatal transfer phase. Includes frontal and axial views on the right margin. The secondary drape is visible, unfolded and attached to the primary drape with adhesive tape at the caudal end, concealing the fenestration. The edge with the adhesive tape is indicated by reference number 6. Figure 5.- Prototype of the invention with neonatal simulator. Front view of the upper surgical field for cesarean section intervention with neonatal transfer. Figure 6.- Prototype of the invention with neonatal simulator. Axial view of the upper surgical field for cesarean section intervention with neonatal transfer. Figure 7.- Prototype of the invention with neonatal simulator. View from the non-sterile side located at the maternal head of the bed during neonatal transfer. PREFERRED EMBODIMENT OF THE INVENTION The following section details an embodiment of the invention, referring to the figures mentioned above. The upper surgical field for cesarean section with neonatal transfer consists of a main drape measuring 2400x1500 mm, made of polypropylene and polyethylene. This drape also includes, firstly, a secondary drape of 500x500 mm and similar composition, rolled up 650 mm from the cranial edge, and secondly, a 400 mm fenestration located 520 mm from the caudal edge, which continues perpendicularly to this fenestration with a 400x400 mm transfer module. This module consists of a double layer of polyethylene with a zip closure at its cranial end, which is placed over the maternal thorax (non-sterile area) (Figure 1).After the newborn is delivered, it is inserted horizontally through the fenestration and slid into the transfer module, which is closed at its cranial margin for the duration of the postpartum uterine procedure (PTCU). During this time, surgical asepsis is maintained while allowing the mother, her companion, and the healthcare team to view the newborn. The secondary drape is folded in on itself and secured with Velcro fasteners (Figures 2, 5, 6). Once the PTCU is completed and the newborn's pulmonary respiration begins, on the non-sterile side located at the maternal head, the transfer module is opened for extraction by the mother, allowing the start of CPP (Figure 3 and 7). Once the newborn transfer is complete, and simultaneously within the sterile surgical field, the obstetrician seals the fenestration by unfolding the secondary drape over it and securing it airtight to the primary drape with adhesive tape. With the fenestration sealed, the transfer circuit is complete, ensuring surgical asepsis (Figure 4).

Claims

1. The upper surgical drape for cesarean section with neonatal transfer comprises a sterile main drape measuring 2400 x 1500 mm when unfolded, made of polypropylene and a polyethylene film, giving it absorbent and waterproof properties. At its cranial portion, 650 mm from the upper edge, a secondary drape measuring 500 x 500 mm and of similar composition is attached and rolled up by two Velcro tabs. At its caudal portion, facing the surgical field, 520 mm from the lower edge, there is a 400 mm fenestration that continues perpendicularly into a 400 x 400 mm transfer module located over the maternal thorax (non-sterile area). This module is transparent and adaptable, consisting of a double layer of polyethylene. Along its entire cranial portion, there is a zip-type opening or closure, also made of polyethylene. 2.Upper surgical field for cesarean section with neonatal transfer, according to claim 1, possessing a fenestration that allows access of the newborn from the sterile surgical field to the maternal thorax (non-sterile area).

3. Upper surgical field for cesarean section with neonatal transfer, according to claim 1, possessing a transfer module with a zip closure that allows the creation of an internal circuit for transferring the newborn, along with the advantages of its composition and transparency that allow for heat retention and continuous visualization of the newborn's color and respiratory movements during the umbilical cord transfer (UCPT) by the mother, companion, and healthcare team.

4. Upper surgical field for cesarean section with neonatal transfer, according to claims 1 and 3, possessing a transfer module in a horizontal position over the maternal thorax that guarantees continuous funicular blood flow, optimizing the UCPT. 5.Upper surgical drape for cesarean section with neonatal transfer, according to claims 1 and 3, the transfer module having a zip closure, which ensures the maintenance of asepsis in the surgical field during PTCU and, secondarily, after opening, provides the opportunity for maternal participation in the delivery, receiving of the newborn, and initiation of PCP.

6. Upper surgical drape for cesarean section with neonatal transfer, according to claim 1, has a secondary 500x500 mm cloth rolled up and secured by two Velcro tabs, and of similar composition. This facilitates the closure of the fenestration once the newborn transfer is complete, closing the internal circuit and maintaining the sterility of the surgical field.

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