EP0290502B1 - Kissen für geburtshilfe - Google Patents

Kissen für geburtshilfe Download PDF

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Publication number
EP0290502B1
EP0290502B1 EP19870907016 EP87907016A EP0290502B1 EP 0290502 B1 EP0290502 B1 EP 0290502B1 EP 19870907016 EP19870907016 EP 19870907016 EP 87907016 A EP87907016 A EP 87907016A EP 0290502 B1 EP0290502 B1 EP 0290502B1
Authority
EP
European Patent Office
Prior art keywords
cushion
obstetrics
thigh pads
thigh
parturient
Prior art date
Legal status (The legal status is an assumption and is not a legal conclusion. Google has not performed a legal analysis and makes no representation as to the accuracy of the status listed.)
Expired - Lifetime
Application number
EP19870907016
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English (en)
French (fr)
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EP0290502A1 (de
Inventor
Jason Otto Gardosi
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Individual
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Individual
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Publication date
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Publication of EP0290502A1 publication Critical patent/EP0290502A1/de
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Publication of EP0290502B1 publication Critical patent/EP0290502B1/de
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Expired - Lifetime legal-status Critical Current

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    • A—HUMAN NECESSITIES
    • A61—MEDICAL OR VETERINARY SCIENCE; HYGIENE
    • A61G—TRANSPORT, PERSONAL CONVEYANCES, OR ACCOMMODATION SPECIALLY ADAPTED FOR PATIENTS OR DISABLED PERSONS; OPERATING TABLES OR CHAIRS; CHAIRS FOR DENTISTRY; FUNERAL DEVICES
    • A61G15/00—Operating chairs; Dental chairs; Accessories specially adapted therefor, e.g. work stands
    • A61G15/005—Chairs specially adapted for gynaecological purposes, e.g. obstetrical chairs

Definitions

  • This invention relates to an obstetrics cushion.
  • an upright position in childbirth offers certain advantages. More particularly, it is thought to promote better alignment of the foetal head with the pelvic inlet to improve the "drive angle" of the pelvis and to lead to stronger and more efficient contractions. There is benefit from the removal (as compared with the supine position) of the weight of the womb from the underlying blood vessels. The force of gravity is made better use of with an upright posture and, finally, it has been shown that with certain upright postures the area of the pelvic outlet is significantly increased. Interest has in recent years revived in a variety of upright postures such as squatting, kneeling, sitting or standing. These postures are referred to in historical works and are also observed in other present-day cultures. In terms of equipment provided for obstetrics use, attention has been primarily focused on the delivery chair which has been put forward as an alternative to the conventional obstetrics bed.
  • the pelvic outlet is defined by the transverse separation of the innominate bones and by the antero-posterior diameter measured from the symphysis of the pelvic bone to the sacrum. It will be recognised that physiological changes in late pregnancy include an increased mouldability of the pelvic joints.
  • the joints between the sacrum and the innominate bones have in their upper parts a shallow ball and socket configuration allowing rocking movement of the sacrum.
  • the lower part of the joint is flatter and allows for sliding of the sacrum, which is in this region generally wedge-shaped. In a squatting position, leverage from the femora on the innominate bones and weight of the trunk acting through the spine, will have the effect of separating the lower parts of the innominate bones and displacing the lower sacrum backward.
  • a sitting position fails to provide or is far less efficient in providing this desirable change in pelvic configuration.
  • a substantial portion of trunk weight is supported through the sacrum with a corresponding reduced proportion being supported through the femora.
  • the leverage exerted upon the innominate bones is significantly reduced as compared with the squatting position.
  • the sacrum may be rotated forward by reaction with the supporting seat surface, leading to a decrease in the antero-posterior diameter which is the opposite to the desired effect. This tilting of the sacrum forward may also pull the lower ends of the innominate bones together so decreasing further the size of the pelvic outlet.
  • FR-A-2 050 277 discloses equipment in the form a collection of cushions.
  • the equipment can be used when exercising in preparation for delivery or during the delivery itself.
  • the equipment does not, however, meet the objects of this invention.
  • the present invention consists in one aspect in an obstetrics cushion having a flat underside to rest upon an obstetrics bed and comprising two separate resilient thigh pads, characterised in that the thigh pads are fixed in spaced relationship on a common base to promote abduction of the parturient's thighs; the upper surface of each thigh pad slopes rearwardly and downwardly and is spaced from the flat underside by a height sufficient in use of the cushion to provide for generally vertical delivery of the foetal head, and the lateral extent and compressability of the thigh pads is such that the adoption by the parturient of a modified squatting position is promoted, with bodyweight being supported mainly through the femora and the thigh pads.
  • the present invention consists in an obstetrics cushion having a flat underside to rest upon an obstetrics bed and comprising two resilient thigh pads, characterised in that the thigh pads are connected at their rear ends in spaced relation by a resilient bridge portion so as in use to underlie the parturient's abducted thighs, the upper surface of each thigh pad slopes rearwardly and downwardly and is spaced from the flat underside by a height sufficient in use of the cushion to provide for generally vertical delivery of the foetal head and the front to back dimension of the resilient bridge portion is small compared with the length of the thigh pads such that the adoption by the parturient of a modified squatting position is promoted with bodyweight being supported mainly through the femora and said thigh pads.
  • the cushion is adapted for use with an obstetric bed having a back support.
  • the obstetric bed is ideally height adjustable.
  • the cushion can be used with an integral or detachable back support.
  • the cushion is provided with handles enabling a force to be exerted through the parturient's arms.
  • the cushion is formed of plastics foam material having a fluid-tight skin.
  • the obstetrics cushion shown generally at 10 in the drawings is formed of relatively firm plastics foam covered with a skin of impervious PVC or other suitable material providing a fluid-tight skin.
  • the grade of foam used in this example is FL35F.
  • the cushion comprises a bridge portion 12 formed integrally with thigh pads 14 and 16. Between the thigh pads, there is defined a cavity which is generally parabolic in plan.
  • the front-to-back dimension of the bridge portion 12 is seen to be considerably less than the length of the thigh pads. In the described example, the ratio of these dimensions is approximately 1:3 and a ratio of at least 1:2 is preferred.
  • the cushion when viewed in side elevation as in Figure 1 takes the form of a trapezium with the angle of inclination of the parallel generally upright edges being selected to match a typical angle between bed surface 18 and back support surface 20.
  • the upper surface of the cushion is arranged to slope downwardly and rearwardly.
  • the cushion may be provided with a strap (not shown) fastened to the back support 20 and secured to the cushion through a burr-type fastener to prevent slippage of the cushion away from the back support.
  • the relatively thin bridge portion 12 undergoes significantly greater vertical compression than the extensive thigh pads 14 and 16. With abduction of the thighs encouraged by the wide spacing of the thigh pads, this compressibility promotes a squatting or near squatting position in which there is relatively little trunk weight supported through the sacrum and a relatively large fraction of trunk weight supported through the femora. Weight is taken mainly through the femora through the thigh pads and, to a smaller extent, through the feet acting on the bed surface. If the parturient is encouraged to slide forwardly away from the bridge portion this weight transfer is accentuated.
  • the squatting or near squatting position provides the advantages outlined above. Leverage in the femora acts to separate the pubic bones to increase the transverse diameter of the pelvic outlet and also the angle between the innominate bones. Not only is the sacrum no longer pushed forward, the movement of the innominate bones and the nature of the sacro-iliac joint also serve to move the sacrum backwards to increase the antero-posterior diameter. It should be recognized, however, that these improvements in pelvic configuration are achieved with the parturient retaining the comfort and the freedom to shift position offered by a bed and the benefit of other features of a delivery bed, particularly height adjustability. The resilience of the cushion according to this invention also increases comfort.
  • a support may be provided over the bed at a height at which it can be gripped by the hands. This offers an alternative squatting posture which may be found more comfortable or more efficient.
  • Use of the cushion enables easy movement between a near squatting position supported by the cushion thigh pads and a "hanging" squatting position in which the bar has a steadying effect.
  • the obstetrics cushion according to this invention can be manufactured inexpensively and it becomes feasible for an obstetrics department to have a cushion for each bed.
  • the sealed nature and uncluttered contours of the cushion facilitate thorough cleaning. If it becomes necessary for the parturient to adopt a supine position, the cushion may simply be removed.
  • a further advantage as compared with birth chairs is that the baby is delivered onto the bed surface.
  • the bed may be provided with side handles below the cushion enabling the parturient to pull herself downwards, effectively increasing body weight and accentuating the described leverage effect in the femora.
  • handles 30 are provided with padding 32 and are supported by an internal frame (not shown).
  • Figure 5 illustrates a rest position, whilst it is seen from Figure 6 that pulling on the handles 30 allows the maternal pushing to be directed downwards in the direction of the birth canal. This has been shown to help the parturient woman to coordinate the pushing efforts in the second stage of labour.
  • the front-to-back dimension of the bridge portion of the cushion is small compared to the length of the cushion thigh pads to promote the described weight transfer.
  • the exact shape of the cushion can, however, be varied.
  • the outlet of the birth canal is elevated above the bed because of the height of the cushion and this, together with the U-shaped configuration of the thigh pads allows the birth attendant good access for controlling the delivery and room for lateral flexion of the baby's shoulders.
  • the actual thickness of the cushion can, however, be varied and will be selected in combination with the compressibility.
  • a variety of materials can be used to produce the cushion although foamed plastics are felt to offer advantages.
  • the grade of foam can of course be selected as appropriate. It is desirable, but not essential, to provide means for securing the cushion to the bed and the described strap is but one example of such an arrangement.
  • the described handles may be provided on the cushion which is for this purpose suitably provided with a rigid base.
  • the orientation of the thigh pads may be determined solely through their respective connections with the base so removing the need for a bridge portion of foamed construction.
  • the base serves as the bridge and the dimension of the bridge in the supporting surface beneath the pelvis has been effectively decreased to zero.
  • This alternative construction with the base serving to connect the two thigh pads may have advantages even where no side handles are provided.
  • Still further means of connecting together the thigh pads may be devised which maintain the desired effect of ensuring that a substantial fraction of the body weight is supported through the femora rather than through the sacrum.
  • the cushion according to this invention is provided with an integral or detachable back support enabling use independently of an obstetric bed, in a home delivery for example.

Landscapes

  • Health & Medical Sciences (AREA)
  • Gynecology & Obstetrics (AREA)
  • Life Sciences & Earth Sciences (AREA)
  • Animal Behavior & Ethology (AREA)
  • General Health & Medical Sciences (AREA)
  • Public Health (AREA)
  • Veterinary Medicine (AREA)
  • Accommodation For Nursing Or Treatment Tables (AREA)
  • Cosmetics (AREA)
  • Orthopedics, Nursing, And Contraception (AREA)

Claims (4)

  1. Entbindungskissen (10) mit einer flachen Unterseite, um auf einem Entbindungsbett aufzuliegen, und mit zwei getrennten elastischen Oberschenkel-Polstern (14, 16) dadurch gekennzeichnet,
    - daß die Oberschenkel-Polster (14, 16) in einer Abstands-Beziehung an einer gemeinsamen Basis befestigt sind, um die Abduktion der Oberschenkel der Gebärenden zu begünstigen;
    - daß sich die obere Oberfläche jedes Oberschenkel-Polsters nach hinten und abwärts neigt und von der flachen Unterseite durch eine Höhe beabstandet ist, die beim Gebrauch des Kissens ausreicht, eine im wesentlichen vertikale Ausgabe des fötalen Kopfes zu ermöglichen; und
    - daß die seitliche Erstreckung und Kompressibilität der Oberschenkel-Polster so ist, daß die Adoption einer modifizierten Hockstellung durch die Gebärende gefördert wird, wobei das Körpergewicht hauptsächlich durch die Oberschenkel-Knochen und die Oberschenkel-Polster abgestützt wird.
  2. Entbindungskissen (10) mit einer flachen Unterseite, um auf einem Entbindungsbett aufzuliegen, und mit zwei elastischen Oberschenkel-Polstern (14, 16), dadurch gekennzeichnet,
    - daß die Oberschenkel-Polster (14, 16) an ihren hinteren Enden in einer Abstands-Beziehung durch einen elastischen Brückenabschnitt (12) verbunden sind, so daß sie beim Gebrauch unter den abduzierten Oberschenkeln der Gebärenden liegen;
    - daß die obere Oberfläche jedes Oberschenkel-Polsters (14, 16) nach hinten und abwärts geneigt ist und von der ebenen Unterseite durch eine Höhe beabstandet ist, die beim Gebrauch des Kissens ausreicht, eine im wesentlichen vertikale Ausgabe des fötalen Kopfes zu ermöglichen; und
    - daß die Front-zu-Rückseite Abmessung des elastischen Brückenabschnitts (12) verglichen mit der Länge der Oberschenkel-Polster Klein ist, so daß die Annahme einer modifizierten Hockstellung durch die Gebärende begünstigt wird, wobei das Körpergewicht hauptsächlich durch den Oberschenkelknochen und die Oberschenkel-Polster abgestützt wird.
  3. Entbindungskissen nach einem der Ansprüche 1 oder 2, das ferner mit Handgriffen (32) versehen ist, so daß eine Kraft durch die Arme der Gebärenden ausgeübt werden kann.
  4. Entbindungskissen nach einem der vorstehenden Ansprüche, das ferner eine integrale Rückenstütze aufweist.
EP19870907016 1986-11-11 1987-10-30 Kissen für geburtshilfe Expired - Lifetime EP0290502B1 (de)

Applications Claiming Priority (2)

Application Number Priority Date Filing Date Title
GB8626897 1986-11-11
GB868626897A GB8626897D0 (en) 1986-11-11 1986-11-11 Obstetrics cushion

Publications (2)

Publication Number Publication Date
EP0290502A1 EP0290502A1 (de) 1988-11-17
EP0290502B1 true EP0290502B1 (de) 1993-05-19

Family

ID=10607129

Family Applications (1)

Application Number Title Priority Date Filing Date
EP19870907016 Expired - Lifetime EP0290502B1 (de) 1986-11-11 1987-10-30 Kissen für geburtshilfe

Country Status (5)

Country Link
EP (1) EP0290502B1 (de)
AU (1) AU8153387A (de)
DE (1) DE3785926T2 (de)
GB (1) GB8626897D0 (de)
WO (1) WO1988003401A1 (de)

Cited By (1)

* Cited by examiner, † Cited by third party
Publication number Priority date Publication date Assignee Title
WO2019185971A1 (en) * 2018-03-29 2019-10-03 Relaxbirth Oy Multifunctional birthing chair

Families Citing this family (3)

* Cited by examiner, † Cited by third party
Publication number Priority date Publication date Assignee Title
DE4207540C2 (de) * 1992-03-10 1993-12-23 Donatello Dr Mancarella Entspannungsgerät zur Geburtsvorbereitung
AU646199B1 (en) * 1992-11-03 1994-02-10 Wayne David Johnson Natal chair
IT201700051540A1 (it) * 2017-05-12 2018-11-12 Andrea Atzori Sedile per travaglio e parto

Family Cites Families (7)

* Cited by examiner, † Cited by third party
Publication number Priority date Publication date Assignee Title
DE220774C (de) *
GB357321A (en) * 1930-07-23 1931-09-24 Thomas Smith A maternity chair
US2104830A (en) * 1937-06-09 1938-01-11 Collard Saby Gertrude Obstetrical chair
FR2050277A1 (de) * 1969-07-22 1971-04-02 Faillieres Jean
US4080968A (en) * 1976-10-06 1978-03-28 Nielsen Irene L Obstetrical support and pan article
GB2127296A (en) * 1982-09-27 1984-04-11 Unimed Inc Apparatus for use in child-birth
NL8400172A (nl) * 1984-01-19 1985-08-16 Beatrijs Smulders Da Costastra Stoel, kruk of dergelijke inrichting voor het ondersteunen van een barende vrouw bij een vertikale bevalling.

Cited By (1)

* Cited by examiner, † Cited by third party
Publication number Priority date Publication date Assignee Title
WO2019185971A1 (en) * 2018-03-29 2019-10-03 Relaxbirth Oy Multifunctional birthing chair

Also Published As

Publication number Publication date
DE3785926T2 (de) 1993-12-16
AU8153387A (en) 1988-06-01
EP0290502A1 (de) 1988-11-17
WO1988003401A1 (en) 1988-05-19
GB8626897D0 (en) 1986-12-10
DE3785926D1 (de) 1993-06-24

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