A lifting device for relieving cephalopelvic disproportion by transvaginal pushing of the fetal head

Abstract

This application provides a lifting device for vaginally pushing the fetal head out of pelvic impaction, comprising: a long rod; a silicone hemispherical sleeve connected to one end of the long rod, with its center facing away from the long rod; a water-filled bladder connected to the end of the long rod and wrapped around the outside of the silicone hemispherical sleeve; and an injection mechanism for injecting physiological saline into the water-filled bladder, wherein the end of the bladder facing away from the long rod after inflation forms a hemispherical groove adapted to the curvature of the fetal head. This application, through the design of the silicone hemispherical sleeve and the water-filled bladder, can conform to the fetal head with a large contact area, preventing frictional damage during contact and greatly reducing harm to the fetus. Furthermore, the physiological saline in the water-filled bladder can dynamically and evenly distribute the lifting force from the operator, solving the difficulty of cesarean section retrieval when the fetal head is deeply embedded in the pelvis, and reducing the probability of neonatal asphyxia, pneumonia, and hypoxic-ischemic encephalopathy.

Description

Technical Field

[0001] This application relates to the field of medical assistive device technology, and in particular to a lifting device for releasing fetal head impaction in the pelvis by pushing the fetal head upward through the vagina. Background Technology

[0002] Fetal head impingement refers to a situation during a cesarean section where the fetal head is deeply embedded in the mother's pelvis and cannot be delivered through routine procedures. Impingement may occur before the cervix is ​​fully dilated, but it is more common during the second stage of labor in a cesarean section. Failed vaginal delivery and subsequent cesarean section often occur due to factors such as persistent occiput transverse position, persistent occiput posterior position, uneven anterior tilt, cephalopelvic disproportion caused by dystocia, labor arrest, or fetal distress. During the second stage of labor, the cervix is ​​fully dilated, and the fetal head reaches or falls below the ischial spines. After a full trial of labor, the fetal head is often deeply embedded in the pelvis, making cesarean section difficult. The surgeon makes a transverse incision in the lower uterine segment and bluntly pulls it about 10 cm, revealing the fetal shoulder. The fetal head is tightly pressed against the posterior pubic symphysis, making it difficult for the surgeon's right hand to enter between the fetal head and the pubic symphysis. During the cesarean section, edema of the lower uterine segment can easily lead to complications such as uterine incision extension, lower uterine segment laceration, uterine artery injury, broad ligament hematoma, cervical, ureteral, and bladder injury, postpartum hemorrhage, and neonatal asphyxia—all life-threatening complications for both mother and child.

[0003] Currently, there are two main methods for deep pelvic fixation cesarean section: the single-blade forceps method and the shoulder traction method. With the single-blade forceps method, due to the urgency of fetal resuscitation during a cesarean section and the time required to prepare auxiliary instruments, improper operation can damage the fetus, causing scalp hematoma or even skull fracture. The shoulder traction method may cause clavicle fracture, and if traction fails, the delivery method needs to be changed. In addition, there is the breech extraction during cesarean section. Because the breech-first, head-later delivery method applies traction rather than direct pressure to the fetal head, the chance of neonatal injury and aspiration is lower, but there have been reports of neonatal fractures.

[0004] Currently, the most commonly used method in my country is the transvaginal head-lifting method. This involves a midwife using her fingers (index, middle, and ring fingers forming a triangle) to push the fetal head upwards near the frontal bone of the skull through the vagina, ensuring the head is flexed and exiting the pelvic cavity with a smaller diameter, thus reducing pressure on the lower uterine segment. The surgeon then catches the fetal head with their right hand and slowly and repeatedly pushes it upwards towards the uterine incision. An assistant presses on the pregnant woman's upper abdomen to assist in the delivery of the fetal head, torso, and limbs. The retrieval of the fetal head is the most critical step. Excessive force during the transvaginal finger-lifting method can cause injury to the fetal head, uterus, and bladder. Furthermore, the time taken for fetal head retrieval is negatively correlated with the neonatal Apgar score; the longer the retrieval time, the lower the Apgar score. If the retrieval time exceeds 150 seconds, the incidence of fetal aspiration of amniotic fluid and neonatal asphyxia increases significantly.

[0005] A related Chinese patent application (CN2024112857724) proposes a pushing device for pushing the fetal head during a cesarean section. The device includes a pushing component and a pressurizing component connected by tubing. The pushing component includes a pushing airbag that can wrap around and push the fetal head. The pressurizing component includes a pressurizing chamber with a piston inside. This device minimizes contact between the fetal head and the operator's hands, reducing the risk of retrograde infection for the pregnant woman. By applying slight negative pressure to the fetal head, it prevents displacement of the pushing airbag during the pushing process, thus ensuring stable pushing force. The pressurizing component ensures uniform pushing force and speed with each pressurization, reducing the risk of fetal head injury from manual pushing. However, using this pushing device requires the top airbag to apply negative pressure to the fetal head. If the pressure point is located on the fetal forehead, face, or fontanelle, it can lead to facial skin damage and intracranial hemorrhage. Utility Model Content

[0006] To address the difficulties in cesarean section when the fetal head is deeply embedded in the pelvis and the potential for fetal injury during instrumentation, this application provides a lifting device for releasing the fetal head from pelvic impaction by pushing it upwards through the vagina.

[0007] The present application provides a lifting device for relieving fetal head impaction in the pelvis by vaginal upward pushing of the fetal head, which adopts the following technical solution: A lifting device for relieving fetal head impaction in the pelvis by vaginal upward pushing of the fetal head, comprising: Long pole; A silicone hemispherical sleeve is attached to one end of the long rod, with its center facing away from the long rod. A water bladder, connected to the end of a long rod and wrapped around the outside of the silicone hemispherical sleeve; and An injection mechanism is used to infuse physiological saline into the water bladder, and after the water bladder is filled, a hemispherical groove is formed at the end opposite to the long rod to fit the curvature of the fetal head.

[0008] Furthermore, a short rod is provided on the side wall of the end of the long rod away from the silicone hemispherical sleeve.

[0009] Furthermore, the injection mechanism includes: An infusion tube is inserted through the long rod, with one end extending into the inner cavity of the water bag and the other end extending out of the long rod; A plug is installed at the end of the infusion tubing that extends beyond the long rod.

[0010] Furthermore, the inner wall of the curved surface of the silicone hemispherical sleeve is fixed with a plurality of support bars arranged radially thereon, and the plurality of support bars are distributed in a circumferential array with equal spacing around the axis of the long rod.

[0011] Furthermore, the long rod is equipped with a control mechanism for driving the multiple support bars to open or close.

[0012] Furthermore, the control mechanism includes: The piston is slidably and sealed at one end of the long rod where the silicone hemispherical sleeve is located, and the support bar is flexibly connected to or hinged to the edge of the piston end face; A control lever is mounted on the piston and slides through the long rod.

[0013] Furthermore, a hollow channel is provided through the long rod, and a long groove communicating with the hollow channel is opened on the side wall of the end of the long rod away from the silicone hemispherical sleeve. The short rod is slidably disposed in the long groove and fixedly connected to the control rod.

[0014] Furthermore, the side wall of the long rod is also provided with a short groove that communicates with both the long groove and the hollow channel, and the short rod is slidably adapted to the short groove; When the short rod is in the short groove, the support bar pushes the silicone hemispherical sleeve to its maximum extended state.

[0015] Furthermore, the control lever is rotatably mounted on the piston, or the short rod is rotatably mounted on the control lever.

[0016] Furthermore, the maximum outer diameter of the water bladder after it is fully inflated is not less than 3 cm.

[0017] In summary, this application includes at least one of the following beneficial technical effects: 1. The basic shaping is achieved by using a silicone hemispherical sleeve to form a cup-shaped soft body for supporting the fetal head. Then, a water bladder filled with physiological saline forms a three-dimensional hemispherical groove, which can fit the fetal head with a large contact area. It will not cause friction damage when contacting the fetal head, greatly reducing the damage to the fetus. 2. The saline solution in the water bladder can dynamically and evenly distribute the lifting force from the operator, which can effectively avoid excessive local lifting pressure on the fetal head caused by the silicone hemispherical sleeve when the lifting direction is not collinear with the long rod. 3. The lifting device of this application solves the difficulty of cesarean section retrieval when the fetal head is deeply embedded in the pelvis, reduces the occurrence of lower uterine segment lacerations, bladder and cervical injuries, and broad ligament hematoma, and also shortens the fetal delivery time, thus reducing the probability of neonatal asphyxia, pneumonia, and hypoxic-ischemic encephalopathy. Therefore, when this device is applied to cesarean section after failed vaginal delivery and fetal head impingement, it can effectively reduce maternal and fetal complications. Attached Figure Description

[0018] To more clearly illustrate the technical solutions in this invention or the prior art, the drawings used in the description of the embodiments or the prior art will be briefly introduced below. Obviously, the drawings described below are some embodiments of this invention. For those skilled in the art, other drawings can be obtained from these drawings without creative effort.

[0019] Figure 1 This is a schematic diagram of the overall structure of Embodiment 1 of this application; Figure 2 This is a longitudinal sectional view of the structure of embodiment 1. Figure 3 This is a schematic diagram of the overall structure of Embodiment 2 of this application after the water bladder is removed; Figure 4 This is a longitudinal sectional view of the structure of embodiment 2.

[0020] Figure label: 1. Long rod; 11. Hollow channel; 12. Long slot; 13. Short slot; 2. Silicone hemispherical sleeve; 3. Water bladder; 31. Hemispherical groove; 4. Short rod; 51. Infusion tubing; 52. Sealing plug; 6. Support strip; 71. Piston; 72. Control lever. Detailed Implementation

[0021] To make the objectives, technical solutions, and advantages of this invention clearer, the technical solutions of this invention will be clearly and completely described below with reference to the accompanying drawings. Obviously, the described embodiments are only some, not all, of the embodiments of this invention. All other embodiments obtained by those skilled in the art based on the embodiments of this invention without creative effort are within the scope of protection of this invention.

[0022] Example 1: Reference Figure 1 and Figure 2 This application discloses a lifting device for relieving fetal head impaction in the pelvis by pushing the fetal head upwards through the vagina, comprising: Long rod 1, approximately 25cm in length, is made of rigid medical plastic; The silicone hemispherical sleeve 2 is connected to one end of the long rod 1, and its center is set away from the long rod 1. Its size is about 3cm×3cm×3cm, but it is not a limitation on the actual size of the silicone hemispherical sleeve 2. The specific size can be designed according to actual needs. Water bladder 3, connected to the end of long rod 1 and wrapped around the outside of silicone hemispherical sleeve 2, has a maximum outer diameter of not less than 3cm when fully inflated; specifically, its inflated dimensions can be 5cm × 5cm × 3cm. The injection mechanism is used to infuse physiological saline into the water bladder 3, and after the water bladder 3 is inflated, a hemispherical groove 31 is formed at the end opposite to the long rod 1 to match the curvature of the fetal head.

[0023] Furthermore, to facilitate the operator's application of force, a short rod 4 is provided on the side wall of the end of the long rod 1 away from the silicone hemispherical sleeve 2.

[0024] Therefore, in clinical practice, if a vaginal examination before surgery reveals that the fetal presentation is below the ischial spines and the fetal head is deeply embedded in the pelvis, the head-up maneuver is required. After epidural anesthesia, the patient is placed in a head-down, feet-up position (at an angle of 20°). The midwife inserts the water-filled balloon 3 and the silicone hemispherical sleeve 2 of the lifting device described in this application into the vagina and holds the distal end of the long rod 1. When closed, the silicone hemispherical sleeve 2 is approximately 3cm × 3cm × 3cm in size, forming a soft silicone hemisphere that will not cause scalp damage upon contact with the fetal head. Then, 200ml of saline is injected into the water-filled balloon 3 through the injection mechanism to inflate it. After inflating, the water-filled balloon 3 enlarges to a hemispherical shape of 5cm × 5cm × 3cm, and its top has a hemispherical groove 31 that can conform to the curved surface of the fetal head.

[0025] The midwife then grasps the long rod 1 and the short rod 4 and pushes them upwards. The surgeon makes a transverse incision 2cm below the peritoneum of the uterosacral reflection and bluntly pulls it to 10cm. The right hand is placed in the gap between the fetal head and the device, and the palm is opened to support the fetal head. Using the strength of the wrist, the fetal head is slowly moved towards the uterine incision. Then, using the back of the right hand as a fulcrum, the assistant presses the fundus of the uterus to assist in the delivery of the fetal head, torso, and limbs. After the fetus is delivered, the midwife uses the injection mechanism to withdraw saline from the device. The top of the water balloon 3 retracts from its inflated state and fits against the 3×3×3cm silicone hemispherical sleeve 2, making it easy to remove it through the vagina.

[0026] Therefore, the silicone hemispherical sleeve 2 is used for basic shaping to form a cup-shaped, soft body for supporting the fetal head. A water-filled saline bladder 3 then forms a three-dimensional hemispherical groove 31, allowing for a large contact area with the fetal head. This prevents friction damage during contact, greatly reducing harm to the fetus. Furthermore, the saline solution in the bladder 3 dynamically and evenly disperses the lifting force from the operator, effectively preventing excessive local pressure on the fetal head caused by misalignment of the lifting direction with the long rod 1. Simultaneously, this lifting device solves the difficulty of cesarean section head retrieval when the fetal head is deeply embedded in the pelvis, reducing the incidence of lower uterine segment lacerations, bladder and cervical injuries, and broad ligament hematoma. It also shortens delivery time and reduces the probability of neonatal asphyxia, pneumonia, and hypoxic-ischemic encephalopathy. Therefore, this device can effectively reduce maternal and fetal complications when fetal head incarceration occurs during a failed vaginal delivery followed by cesarean section.

[0027] In addition, the aforementioned injection facilities include: The infusion tube 51 is inserted into the long rod 1, with one end extending into the inner cavity of the water bag 3 and the other end extending out of the long rod 1; The stopper 52 is installed at the end of the infusion tube 51 that extends beyond the long rod 1, and is specifically a commonly used medical rubber stopper.

[0028] Therefore, the plug 52 can be punctured with a syringe, and saline can be injected into the water balloon 3 through the infusion tube 51, so that the water balloon 3 can be inflated after passing through the patient's vagina, which facilitates the equal pressure lifting of the fetal head; after the operation is completed, the saline in the water balloon 3 can be withdrawn with the help of the infusion tube 51, so that the water balloon 3 shrinks to fit tightly against the outer wall of the silicone hemispherical sleeve 2, which can be easily removed from the patient's vagina without injury.

[0029] Example 2: Reference Figure 3 and Figure 4 The difference from Example 1 is that: Furthermore, multiple support bars 6 are fixed to the inner wall of the arc surface of the silicone hemispherical sleeve 2, which are arranged radially. The multiple support bars 6 are distributed in a circumferential array with equal spacing around the axis of the long rod 1. The support bars 6 are made of rigid plastic or plastic with a certain degree of elasticity.

[0030] The long rod 1 is equipped with a control mechanism for driving multiple support bars 6 to open or close. Specifically, the long rod 1 is hollow with both ends open, and the control mechanism includes: The piston 71 is sealed and slidably disposed at one end of the long rod 1 with a silicone hemispherical sleeve 2. The support bar 6 is flexibly connected or hinged to the edge of the piston 71 end face. The aforementioned infusion tube 51 passes through the piston 71 and communicates with the inner cavity of the water bag 3. The control lever 72 is mounted on the piston 71 and slides through the long rod 1.

[0031] Therefore, by pulling or pushing the control lever 72, the piston 71 can slide at the end of the long rod 1, causing the support bar 6 to rotate on the piston 71 with the end of the long rod 1 as the fulcrum. This causes the silicone hemispherical sleeve 2 to open or close, thus achieving a flexible adjustment effect on the silicone hemispherical sleeve 2. Specifically, when the piston 71 causes the silicone hemispherical sleeve 2 to close, the outer diameter of the device at the end of the long rod 1 can be further reduced, thereby reducing the probability of damage to the silicone hemispherical sleeve 2 and the water bladder 3 when passing through the patient's vagina. When the piston 71 causes the silicone hemispherical sleeve 2 to open, the multiple rigid support bars 6 can support the cup shape of the silicone hemispherical sleeve 2 as a whole, effectively preventing it from becoming unstable or tilting to one side. When the silicone hemispherical sleeve 2, which is the main body of the shaping, is stably supported, the supporting shape of the water bladder 3 wrapped around the outside is also basically stable, thus ensuring the stability of the lifting device of this application when lifting the fetal head.

[0032] In addition, to further improve ease of operation, another feasible embodiment is proposed.

[0033] A hollow channel 11 is provided through the long rod 1. A long groove 12 communicating with the hollow channel 11 is opened on the side wall of the long rod 1 at the end away from the silicone hemispherical sleeve 2. The short rod 4 is slidably disposed in the long groove 12 and fixedly connected to the control rod 72. A short groove 13 communicating with both the long groove 12 and the hollow channel 11 is also opened on the side wall of the long rod 1. The short rod 4 is slidably adapted to the short groove 13. The short groove 13 and the long groove 12 are in an "L" shape. When the short rod 4 is located in the short groove 13, the support bar 6 pushes the silicone hemispherical sleeve 2 to the maximum unfolded state.

[0034] Furthermore, the control rod 72 is rotatably mounted on the piston 71, or the short rod 4 is rotatably mounted on the control rod 72. In this embodiment, the connection structure between the control rod 72 and the piston 71 is similar to the structure of the rubber stopper and push-pull rod in a conventional syringe, and will not be described in detail here.

[0035] Therefore, the short rod 4 can be used as a force-assisting structure during operation, and the control rod 72 can be pulled by sliding the short rod 4 in the long groove 12, thereby realizing the opening and closing of the silicone hemispherical sleeve 2 driven by the piston 71, making the operation more convenient; moreover, when the piston 71 moves to push the silicone hemispherical sleeve 2 to open, the short rod 4 can be rotated so that the short rod 4 rotates into the short groove 13. At this time, the movement of the control rod 72 in the length direction of the long rod 1 is restricted, that is, the silicone hemispherical sleeve 2 is kept in the open state under the support of multiple support bars 6, which makes it convenient for the operator to lift the fetal head.

[0036] Finally, it should be noted that the above embodiments are only used to illustrate the technical solutions of the present invention, and not to limit them; although the present invention has been described in detail with reference to the foregoing embodiments, those skilled in the art should understand that modifications can still be made to the technical solutions described in the foregoing embodiments, or equivalent substitutions can be made to some of the technical features; and these modifications or substitutions do not cause the essence of the corresponding technical solutions to deviate from the spirit and scope of the technical solutions of the embodiments of the present invention.

Claims

1. A lifting device for releasing fetal head impaction in the pelvis by pushing the fetal head upwards through the vagina, characterized in that, include: Long pole; A silicone hemispherical sleeve is attached to one end of the long rod, with its center facing away from the long rod. A water bladder, connected to the end of a long rod and wrapped around the outside of the silicone hemispherical sleeve; and An injection mechanism is used to infuse physiological saline into the water bladder, and after the water bladder is filled, a hemispherical groove is formed at the end opposite the long rod to adapt to the curvature of the fetal head.

2. The lifting device for relieving fetal head impaction in the pelvis by vaginal upward pushing of the fetal head according to claim 1, characterized in that, A short rod is provided on the side wall of the end of the long rod away from the silicone hemispherical sleeve.

3. The lifting device for relieving fetal head impaction in the pelvis by vaginal upward pushing of the fetal head according to claim 1, characterized in that, The injection mechanism includes: An infusion tube is inserted through the long rod, with one end extending into the inner cavity of the water bag and the other end extending out of the long rod; A plug is installed at the end of the infusion tubing that extends beyond the long rod.

4. A lifting device for relieving fetal head impaction in the pelvis by vaginal upward pushing of the fetal head, as described in claim 2, is characterized in that... The inner wall of the curved surface of the silicone hemispherical sleeve is fixed with a plurality of support bars arranged radially thereon, and the plurality of support bars are distributed in a circumferential array with equal spacing around the axis of the long rod.

5. A lifting device for relieving fetal head impaction in the pelvis by vaginal upward pushing of the fetal head, as described in claim 4, is characterized in that... The long rod is equipped with a control mechanism for driving the multiple support bars to open or close.

6. A lifting device for relieving fetal head impaction in the pelvis by vaginal upward pushing of the fetal head, as described in claim 5, is characterized in that... The control mechanism includes: The piston is slidably and sealed at one end of the long rod where the silicone hemispherical sleeve is located, and the support bar is flexibly connected to or hinged to the edge of the piston end face; A control lever is mounted on the piston and slides through the long rod.

7. A lifting device for relieving fetal head impaction in the pelvis by vaginal upward pushing, as described in claim 6, characterized in that, A hollow channel is provided through the long rod, and a long groove communicating with the hollow channel is opened on the side wall of the end of the long rod away from the silicone hemispherical sleeve. The short rod is slidably disposed in the long groove and fixedly connected to the control rod.

8. A lifting device for relieving fetal head impaction in the pelvis by vaginal upward pushing of the fetal head, as described in claim 7, is characterized in that... The side wall of the long rod is also provided with a short groove that communicates with both the long groove and the hollow channel, and the short rod is slidably adapted to the short groove; When the short rod is in the short groove, the support bar pushes the silicone hemispherical sleeve to its maximum extended state.

9. A lifting device for relieving fetal head impaction in the pelvis by vaginal upward pushing of the fetal head, as described in claim 8, is characterized in that... The control lever is rotatably mounted on the piston, or the short rod is rotatably mounted on the control lever.

10. A lifting device for relieving fetal head impaction in the pelvis by vaginal upward pushing of the fetal head, as described in claim 1, characterized in that... The maximum outer diameter of the water bladder when fully inflated is not less than 3 cm.

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