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<https://discovery.ucl.ac.uk/id/eprint/10205176> <http://purl.org/dc/terms/title> "Can we improve the prediction,  process, and outcome of  operative birth through advanced  imaging, novel surgical tools, and  training?"^^<http://www.w3.org/2001/XMLSchema#string> .
<https://discovery.ucl.ac.uk/id/eprint/10205176> <http://purl.org/ontology/bibo/abstract> "Childbirth is one of the most important moments of a person’s life. Operative vaginal \r\nbirth (OVB) and caesarean section (CS) account for a large proportion of these births,\r\nand can carry significant risk to both the mother and neonate if not performed by skilled \r\npractitioners. Despite how common operative birth is, the ability to predict mode of \r\nbirth, and to appropriately counsel patients, still eludes Obstetricians. Furthermore, \r\nalthough various imaging techniques, such as ultrasound scan, can predict the \r\nsuccess of OVB, there are no intrapartum tools to aid in performing such deliveries. \r\nRates of OVB are decreasing whilst rates of second stage CS are increasing. It is \r\nthought that a decrease in trainee exposure, as well as in confidence, are significant \r\ncontributors to such trends. Lack of skills or confidence in supervision likely compound \r\nthe problem.\r\nThe work presented in this thesis therefore aimed to explore whether magnetic \r\nresonance imaging and pelvimetry/fetal biometry could predict mode of birth, and \r\nwhether a novel imaging protocol in late third trimester was feasible. In a collaboration \r\nbetween Engineers and Obstetricians, we also explored whether a novel sensorised \r\nglove could aid in OVB by diagnosing fetal position and anal sphincter injury. A new\r\npractical course on OVB and complex CS was developed, aimed to increase \r\nconfidence levels of senior trainees. \r\nThis thesis found no pelvimetry/biometry values can accurately predict mode of birth\r\nat present, but a novel imaging protocol, with the addition of markers of placental \r\nfunction, is feasible in late third trimester, and should be tested in a large scale study. \r\nFurthermore, although we cannot currently predict mode of birth, the novel sensorised \r\nglove shows promise in improving the safety and success of OVB. A new course on \r\nOVB significantly improved trainee confidence levels. It remains to be seen if we can \r\nimprove the prediction of OVB. With clinical translation of the novel sensorised glove, \r\nand enhanced training for senior trainees, the future of OVB is positive."^^<http://www.w3.org/2001/XMLSchema#string> .
<https://discovery.ucl.ac.uk/id/eprint/10205176> <http://purl.org/dc/terms/date> "2025-02-28" .
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