Meet 'Desperate Debra' – the caesarean simulator that will help doctors to save the lives of pregnant women

She may have no arms or legs, but 'Desperate Debra' is poised to play a crucial role in training up NHS doctors.

The silicone dummy is the first emergency caesarean simulator and will aid medics in dealing with challenging and dangerous births.

Guy's and St Thomas' NHS Foundation Trust is the first to use the model, which mimics advanced labour where the baby's head gets stuck in the mother's pelvis.

In the UK around 20,000 births per year are affected by late-stage caesareans that can be life-threatening for both mother and child.

Demonstrating Debra: The simulator is highly realistic in terms of how the baby¿s head and neck move

'Emergency caesareans at full dilatation can be challenging and dangerous,' says Professor Andrew Shennan, from Guys’ and St Thomas’, who helped to develop Desperate Debra.

'This problem is usually encountered late at night, when doctors with experience of this situation may not be available. Using Desperate Debra to help train doctors in this scenario should reduce the likelihood of serious complications for the infant and mother.'

 

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Trial groups at Guy’s and St Thomas’ NHS Foundation Trust revealed that 80 per cent of obstetric surgeons have experienced difficulties with the baby’s head during an emergency caesarean, while 70 per cent have encountered cases where the mother and/or baby has died.

Made of silicone and plastic, Desperate Debra consists of a pregnant abdomen, uterus and foetus, and it is possible to adjust the difficulty of delivery.

Training day: Debra includes a pregnant abdomen, uterus and foetus

'Making Desperate Debra was very technically challenging,' said Gabriel Ogwo from manufacturer Adam,Rouilly.

'We had to work closely with Guys’ and St Thomas’ and NHS Fife to ensure that we simulated lifelike movement and feel.'

'Desperate Debra is highly realistic in terms of how the baby’s head and neck moves – it feels fragile,' says Dr Graham Tydeman, from NHS Fife, who has been involved with hundreds of emergency caesareans over 25 years.

'I wish I’d had the chance to train with a simulator before encountering the real thing.'

Debra joins a family of simulator devices including Resusci Annie - a training mannequin used for teaching CPR to both emergency workers and members of the public.

Read more: http://www.dailymail.co.uk/health/article-2169186/Desperate-Debra--simulator-helping-train-doctors-perform-emergency-caesareans.html#ixzz1zlujc3xQ

Women having fertility treatment may be better off using frozen embryo rather than 'fresh'

A new study shows there is a 30 per cent higher chance of getting pregnant with a frozen embryo.

It suggests there are advantages to waiting for the womb to settle down after drug treatment and the approach also avoids the risk of drug side effects in the mother.

A technician works with frozen embryos. A study suggests they are 30 per cent more effective than 'fresh' ones

Fertility experts believe IVF treatment may subtly affect the womb environment, making it more difficult for the growing baby to thrive.

The procedure has become increasingly popular over the last 10 years as it saves 'wasting' extra embryos created from initial drug treatment.

It also reduces the cost of the next cycle of treatment as drugs are unnecessary, although there are modest storage fees to keeping embryos in the deep freeze.

Spanish researchers said it would soon be possible to recommend a freeze-all policy to doctors and women, in which all embryos used in IVF were frozen first.

The study was presented at the annual meeting of the European Society of Human Reproduction and Embryology in Istanbul, Turkey.

Professor Miguel Angel Checa from the Hospital Universitari del Mar in Barcelona, who led the study, said currently women having embryos implanted straight after drug treatment ran the risk of ovarian hyperstimulation syndrome (OHSS).

This results in over-stimulation of the ovaries and can rarely lead to death.
He said a freeze-all approach can extend the success rates of IVF and improve safety for patients.

 

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He said: 'When we freeze all of the embryos we collect we would avoid the biggest complication that exists in assisted reproduction.' 

Previous research shows IVF babies born from frozen embryos are heavier and result in longer pregnancies - reducing the rate of premature babies - than those born from fresh embryos.

Freezing embryos enables couples to have several cycles of IVF with eggs collected during one round of treatment. By putting some on ice, couples can use up their fresh embryos before moving on to frozen ones at a later date.

In the study of 633 IVF cycles, 316 women were randomly assigned to have an embryo transferred to the womb immediately after drug treatment.
The other 317 women had all their embryos frozen and one transferred after thawing at a later date.

There was a pregnancy rate of 38 per cent for women using fresh embryos and 50 per cent for the frozen embryo cycles - a relative improvement of 30 per cent.

Prof Checa said the drug treatment needed to produce a multiple supply of eggs affects the receptivity of the lining of the women, making it less likely that a transferred embryo will implant.

He said OHSS affects between one and five per cent of women having IVF drugs to produce eggs.

The problem of over-stimulation is triggered by pregnancy, when the embryo implants, but would be eliminated by waiting for the drugs to clear from the body before using frozen and thawed embryos.

In 2008, Danish scientists also found that babies born after frozen embryo transfer had higher birth weights than those born from fresh embryos.

They suggested only top quality embryos survive the freezing and thawing process.

Professor Geeta Nargund, medical director of the Create Fertility Clinics, uses a kinder form of IVF which spares the woman exposure to drug hormones.

She said drug treatment can lead to over-stimulation of the ovaries, which could be dangerous.

She said: 'The study suggests that conventional drug treatment affects the lining of the womb and freezing embryos helps improve the situation.

'But we need to use low-dose or drug free techniques in IVF for the health of the mother and the baby.' 

Read more: http://www.dailymail.co.uk/health/article-2168710/Women-having-fertility-treatment-better-using-frozen-embryo-fresh.html#ixzz1zfIX3Ig3