"Desperate Debra" preps surgeons for tricky C-sections
July 4, 2012
Though its makers describe Desperate Debra as "the world's first impacted fetal head simulator," it's perhaps simpler to describe it as a practice dummy for caesarean sections carried out due to the baby's head having become wedged in the mother's pelvis: a situation known as impaction. It's a potentially life-threatening complication and one that is tricky to rectify. Manufacturer of medical simulators Adam,Rouilly has come up with Desperate Debra so that surgeons may practice the procedure.
Adam,Rouilly developed Desperate Debra in collaboration with the UK National Health Service and Guy's and St Thomas' Hospital in London. The company claims that its trial groups indicate that 80 percent of surgeons have had direct experience fetal head impaction, and 70 percent are aware of cases where impaction has resulted in the death of either mother or child.
These figures are far from being an indicator of impaction rates (and even further from morbidity rates), but Adam,Rouilly estimates that that impaction has the potential to affect 20,000 births per year in the UK alone.
Desperate Debra is a remarkably detailed model, including as it does a pelvic bone (cast from a life, if not live, subject), a simulated uterus and, of course, a fetal head complete with the fontanelles which allow a baby's skull to flex during birth.
Adam,Rouilly claims that many surgeons' first encounters with fetal head impaction occur in training, and often at night when there is no experienced help on hand. "Desperate Debra is highly realistic in terms of how the baby's head and neck moves - it feels fragile," Graham Tydeman of NHS Fife told Wired UK. "I wish I'd had the chance to train with a simulator before encountering the real thing." That's saying something, considering Tydeman's been involved in about 2000 C-sections.
Techniques to deal with impaction vary, from pushing the baby's head through the vagina, or pulling its legs through the caesarean incisions, but such techniques can cause further complications. In addition to merely giving surgeons practice (and therefore confidence) in dealing with cases of impaction, Adam,Rouilly hopes the model will lead to the development of refined emergency procedures and techniques.