SPECIAL DELIVERY

PASSING A BABY through a woman's bony pelvis is an engineering problem, says Robert H. Allen, an associate professor of biomedical engineering at Baltimore's Johns Hopkins University. Doctors and midwives are sometimes working with only a centimeter or two to spare. And in 5 percent of births, shoulder dystocia occurs: That's when the baby's shoulders can't get through the pelvis. In 25 percent of those cases, the babies receive injuries to their brachial plexus nerves, which control arm movement and sensation. But a team led by Alien has built a birthing simulator that allows doctors to practice techniques for mitigating dystocia. The device has rubber gloves lined with force sensors that indicate how much traction is used by the deliverer.

There are three standard delivery procedures used for dystocia deliveries. One involves turning the baby so its spine faces the mother's belly; the second involves turning the baby so its spine aligns with the mother's spine; the third method is raising the mother's legs. A study conducted by the university's hospital determined that the first method required putting the least amount of force on the baby's head. Alien expects the birthing simulator to become a useful teaching tool; since dystocia births are fairly rare, even veteran obstetricians should find the trainer useful. Also, the device could be revamped to simulate other delivery-room scenarios, from breech births to forceps deliveries.-TG

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