Monitoraggio Strumentale del
Travaglio di Parto
Sergio CASCIARO, PhD, Eng
CONSIGLIO NAZIONALE DELLE RICERCHE – I.F.C.
Dip. di Ingegneria Biomedica, Scienze e Tecnologie Mediche
Lecce, Italy
Lodi, 15 maggio 2010
Programma della presentazione…
 Introduzione
• Gestione del parto
• Necessità Strumentale
 Strumentazione Disponibile per la
cervicometria
 Dispositivo in fase di sviluppo
 Conclusioni
INTRODUZIONE
Intro - Medical Decision Taking
 In Italy, the average national rate of caesarean
sections is equal to 38%, against an ideal 15%
recommended by the World Health Organization.
 Moreover, those values are much higher than the
average European rate (23,7%).
 New methods and technologies for standardised
quantitative monitoring and appropriate medical
decision taking.
Intro - Labor Monitoring
 Nowadays in most Obs Dpts MANUAL DIGITAL CHECKS
represent the only way of monitoring cervix dilatation (1
Pmt!)
 A systematic and CONTINUOUS MONITORING would
provide great benefit in order to early diagnose pathologic
labor (distocia and other COMPLICATIONS)
 Furthermore, real time monitoring and parameter recording
would reduce LEGAL LITIGATIONS and related costs
Labor Monitoring - Partogram
PARTOGRAM (Friedman 1954…!!) consists of measuring 2
parameters: Cervix Dilatation and Head Station.
Labor Monitoring - SOLUTIONS
Possible Practical SOLUTIONS for
Labor Monitoring Improvements:
1. Echographic Monitoring performed by Experts
(short term and long term!!!)
2. New Technologies and Methods for non-invasive
and accurate Automatic Quantitative Monitoring
SISTEMI
COMMERCIALI
Labor Monitoring Devices: State of the Art
BirthTrack System (Barnev Inc., Andover, MA, USA;
Barnev Ltd., Netanya, Israel)
LaborPro System (Trig Medical Inc., Ridgefield, NJ,
USA; Trig Medical Ltd., Yoqneam Ilit , Israel)
SonoVCADlabor (GE Healthcare 9900 Innovation
Drive Wauwatosa, WI 53226 U.S.A.)
Labor Monitoring Devices: State of the Art
Last years two products commercially appeared which
enable cervix dilation and head station measurement (2
Pmts), not commonly employed due to strong Limitations
(Post membrane rupture, cable sensors inserted in vagina)
BirthTrack System
(Barnev Inc., Andover, MA, USA;
Barnev Ltd., Netanya, Israel)
LaborPro System
(Trig Medical Inc., Ridgefield, NJ, USA;
Trig Medical Ltd., Yoqneam Ilit , Israel)
Labor Monitoring Devices: State of the Art
Last year a software SonoVCADlabor for quantification of
Labor parameters through 3D translabial sonography
(Ghi et al. 2009)
SonoVCADlabor (GE Healthcare 9900 Innovation
Drive Wauwatosa, WI 53226 U.S.A.)
NUOVO SISTEMA IN
FASE DI SVILUPPO
BREVETTI CNR:
MONDO
“Ultrasonic apparatus for measuring a labor progress
parameter”
APPLICATION N°: PCT/EP2009/008321
ITALY
“Apparato basato sugli ultrasuoni per misurare
parametri indicatori di avanzamento di un parto”
APPLICATION N°: PI 2008 A118
Ultrasound Labor Monitoring
Main New Features of patented systems:
 Quantitative external “non invasive” automatic
measurement of main indicators of labor progress during
all stages (1°, 2° and 3° stages)!
Ultrasound Labor Monitoring
 MAIN INDICATORS OF INTEREST WE CAN NOW MEASURE
DURING LABOR:
 Contractions (frequency, duration, etc)
 Head Station
 Head and Shoulder Position
 Cervical Dilatation
 Others (Heartbeating of Fetus,…)
 Monitoring in Real Time Referring to anatomical sites and
personalized to the specific case
 Recording of Parameters for research and to reduce potential
legal litigations
 Automatic Correlation and Warning through Neural Networks for
medical decision support (…Caesarean Section)
 Intuitive User Interaction  low learning time.
New System for Labor Monitoring: Introduction
New System for Labor Monitoring: Main Features
New System for Labor Monitoring: Main Features
Accuracy of the employed algorithm (Errors are expressed as bias ± 2SD,
according to the Bland-Altman statistics).
Conclusion
Ultrasound Labor Monitoring
 After our preliminary tests quantitative external “non invasive”
automatic measurement of main indicators of labor progress during
all stages result to be feasible in a robust and reliable manner.
 Labor complications would be earlier diagnosed and properly
managed reducing risks for both mothers and newborns.
 By recording the all parameters of interest legal litigation would be
reduced and the learning of doctors improved.
 Given the available algorithms and available related expertise time to
market could be extremely reduced.
 This system would bring great benefit to pregnancy management,
reduce costs and facilitate doctors supporting them in their
decisions and operations by mean of quantitative automatic
approach.
Thank you
for your attention
E-mail: [email protected]