TY  - UNPB
ID  - discovery10205176
N2  - Childbirth is one of the most important moments of a person?s life. Operative vaginal 
birth (OVB) and caesarean section (CS) account for a large proportion of these births,
and can carry significant risk to both the mother and neonate if not performed by skilled 
practitioners. Despite how common operative birth is, the ability to predict mode of 
birth, and to appropriately counsel patients, still eludes Obstetricians. Furthermore, 
although various imaging techniques, such as ultrasound scan, can predict the 
success of OVB, there are no intrapartum tools to aid in performing such deliveries. 
Rates of OVB are decreasing whilst rates of second stage CS are increasing. It is 
thought that a decrease in trainee exposure, as well as in confidence, are significant 
contributors to such trends. Lack of skills or confidence in supervision likely compound 
the problem.
The work presented in this thesis therefore aimed to explore whether magnetic 
resonance imaging and pelvimetry/fetal biometry could predict mode of birth, and 
whether a novel imaging protocol in late third trimester was feasible. In a collaboration 
between Engineers and Obstetricians, we also explored whether a novel sensorised 
glove could aid in OVB by diagnosing fetal position and anal sphincter injury. A new
practical course on OVB and complex CS was developed, aimed to increase 
confidence levels of senior trainees. 
This thesis found no pelvimetry/biometry values can accurately predict mode of birth
at present, but a novel imaging protocol, with the addition of markers of placental 
function, is feasible in late third trimester, and should be tested in a large scale study. 
Furthermore, although we cannot currently predict mode of birth, the novel sensorised 
glove shows promise in improving the safety and success of OVB. A new course on 
OVB significantly improved trainee confidence levels. It remains to be seen if we can 
improve the prediction of OVB. With clinical translation of the novel sensorised glove, 
and enhanced training for senior trainees, the future of OVB is positive.
PB  - UCL (University College London)
UR  - https://discovery.ucl.ac.uk/id/eprint/10205176/
M1  - Doctoral
A1  - Jaufuraully, Shireen Rebecca Yi Xuan
TI  - Can we improve the prediction,  process, and outcome of  operative birth through advanced  imaging, novel surgical tools, and  training?
EP  - 321
Y1  - 2025/02/28/
AV  - public
N1  - Copyright © The Author 2025. Original content in this thesis is licensed under the terms of the Creative Commons Attribution-NonCommercial 4.0 International (CC BY-NC 4.0) Licence (https://creativecommons.org/licenses/by-nc/4.0/). Any third-party copyright material present remains the property of its respective owner(s) and is licensed under its existing terms. Access may initially be restricted at the author?s request.
ER  -