Background: Manual perineal protection (MPP) is an intrapartum intervention suggested to protect perineal integrity during childbirth. Proper execution of MPP is complex and evaluation of its true contribution is difficult in the clinical setting because of the large number of obstetric variables, some of which are hardly quantifiable. In this study we aimed to gather initial data on the forces executed by the accoucheur's thumb, index and middle fingers during MPP at the time of fetal head expulsion, quantify the duration of the intervention and investigate the timely interaction of the different components of MPP. Methods: Two bespoke right-handed measurement gloves (MG), with built in sensors, were designed and produced. The MG allowed the electronic real-time measurement of applied forces during MPP and transferred this data wirelessly to an integrated computer system. Sterile gloves were worn over the MG when used at the time of birth. The study was undertaken between January and December 2019. Singleton, term pregnant women having their first vaginal birth who provided a valid written consent were enrolled into this prospective pilot study. All deliveries were undertaken by one of two obstetricians experienced in MPP. Results: Twenty women were enrolled. The mean duration of execution of MPP during the last contraction was 13.6 s. In 20% it lasted < 5 s. The overall mean values of the average and maximum forces of the thumb, index and middle fingers were 26.7 N; 25.5 N; 20.2 N and 34.3 N; 32.6 N; and 27.6 N respectively. The onset of fingers and thumb activity was simultaneous in 13 cases (65%), while in seven (35%) deliveries the middle finger's force activity was initiated later. Conclusions: MPP during fetal head expulsion happens over a short period of time. In the majority of cases the thumb and fingers actions started simultaneously. There were differences in the duration of application and the forces executed by the fingers and thumb between the two practitioners, however this was only significant for thumb measurements. The results obtained will aid in improving further MPP modeling studies to optimize the technique.
Wireless communication technologies together with physiological signals sensing provide a wide range of capabilities for monitoring, recording and analysis of the physical and health status of individuals. This paper describes two systems using wireless transmission of information designed to measure physiological signals. The first system is system for automatic cardiopulmonary examination measuring and evaluating. The system measures heart rate, pulmonary ventilation, breathing frequency and blood pressure. From these data, many of other standard parameters are calculated. Application of this system is possible in work medicine, sport medicine and rehabilitation. The second system is a system for measuring and wireless transmission of selected physiological signals and variables. The system consists of wireless sensors, data transceivers and information system for the visualization and analysis of measurement data. This paper describes sensor for monitoring of body temperature and RF transceiver, which are being developed as part of the system. Temperature sensor is due to its high demand on low energy consumption not suitable for measuring signals, which will produce large amount of data and therefore consumes more energy on wireless transmission and processing of the data. Due to this reason, this sensor does not measure other signals and measure only temperature so fare. Other sensors, which will measure more physiological signals, like pulse rate, ECG and motion activity of monitored person will be developed in future. Possible use of the sensor or whole system is in a medical environment.
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