The Development of a Forceps-Adaptable Pressure Device for Instrumental Delivery: A Proof-of-Concept Study for Clinical and Educational Applications.

Objective: To develop and validate a device that measures the pressure exerted by forceps on the fetal head for clinical use.

Background: The lack of clinical tools to quantify forceps pressure on the fetal head may impact maternal and neonatal outcomes. Existing studies have not measured the direct contact pressure between forceps blades and the fetal head, highlighting the need for innovation.

Methods: We integrated fluid pressure transducers into obstetric forceps using fluid-filled tubing encased in flexible silicone socks attached to the blades. Tubing materials-polyvinyl chloride (PVC) and polyurethane (PU)-and fluids (air and water) were tested with both biocompatible and non-biocompatible silicone socks. An onboard electronic board collected pressure data and transmitted them via Bluetooth for real-time analysis. The system was evaluated on a custom-built bench simulating forceps application.

Results: Air-filled tubing exhibited significant drift and low accuracy due to air compressibility. Water-filled PU tubing reduced drift but was still suboptimal. Water-filled PVC tubing with both types of silicone socks provided the best results, showing minimal drift and a strong correlation between measured pressures and applied forces.

Conclusions: The developed device represents a significant advancement, as no existing system measures the pressure exerted by forceps blades on the fetal head. By effectively measuring pressure across the entire contact surface in real time, it offers applications in both training and clinical practice. The device allows for objective feedback, potentially improving the safety and efficacy of forceps deliveries. Future work includes comprehensive mannequin tests and eventual in vivo studies to validate its effectiveness in realistic settings, aiming to enhance obstetric training and reduce maternal and neonatal complications.