U.S. patent number 3,794,044 [Application Number 05/190,779] was granted by the patent office on 1974-02-26 for delivery forceps.
This patent grant is currently assigned to Ethyl Corporation. Invention is credited to Arthur L. Decker, William O. Vennard.
United States Patent |
3,794,044 |
Vennard , et al. |
February 26, 1974 |
DELIVERY FORCEPS
Abstract
A method and apparatus for assisting in the delivery of a fetus
from a womb which includes surrounding the upper portion of the
head of the fetus with a plurality of flexible fingers contoured
generally to the shape of the fetus's head and securing the fingers
to the fetus and then applying a pull to the fingers to assist in
the delivery of the fetus from the womb. A thin membrane may be
provided to interconnect the fingers whereby a vacuum may be
applied to further secure the fingers and membrane to the head of
the fetus.
Inventors: |
Vennard; William O. (Baton
Rouge, LA), Decker; Arthur L. (Baton Rouge, LA) |
Assignee: |
Ethyl Corporation (Richmond,
VA)
|
Family
ID: |
22702738 |
Appl.
No.: |
05/190,779 |
Filed: |
October 20, 1971 |
Current U.S.
Class: |
606/123 |
Current CPC
Class: |
A61B
17/442 (20130101) |
Current International
Class: |
A61B
17/42 (20060101); A61B 17/44 (20060101); A61b
017/44 () |
Field of
Search: |
;128/352,353,323,324,303,345,361 |
References Cited
[Referenced By]
U.S. Patent Documents
Primary Examiner: Laudenslager; Lucie H.
Attorney, Agent or Firm: Johnson; Donald L.
Claims
What is claimed is:
1. In an apparatus for assisting in delivery of a fetus from a
womb, the combination comprising:
a. housing means including an elongated hollow body having a
cylindrical bore therein;
b. a generally cylindrical sleeve slidably received in said
body;
c. a plurality of flexible fingers attached to one end of said
sleeve, said fingers being extendable from and retractable into
said body by relative movement between said body and said
sleeve;
d. a guide rod axially received within said body and said sleeve,
and having means at one of its ends for flairing outwardly said
fingers when said fingers are extended from said body; and
e. means to secure said fingers to said head of said fetus.
2. In the apparatus of claim 1 wherein said securing means includes
a cord having a noose portion connected to said fingers.
3. In the apparatus of claim 1 wherein said securing means includes
a continuous, thin, flexible membrane connecting all of said
fingers.
4. In the apparatus of claim 1 wherein said securing means includes
a cord having a noose portion connected to the outer ends of said
fingers and a continuous, thin, flexible membrane connecting all of
said fingers.
5. In the apparatus of claim 2 wherein means to tighten said noose
is provided.
6. In the apparatus of claim 3 wherein means are provided for
evacuating the space between said membrane and said head of said
fetus to securely attach said membrane and said fingers to said
head of said fetus.
7. In an apparatus for assisting in the delivery of a fetus from a
womb, the combination comprising:
a. an elongated support body having an axial bore extending
therethrough;
b. a guide rod having a diameter smaller than said bore fixedly,
axially positioned within said bore and having at least one end
extending outwardly therefrom;
c. a sleeve slidably mounted on said guide rod for movement into
and out of said bore in said body;
d. a plurality of flexible fingers attached at their inner ends to
one end of said sleeve, said fingers adapted to be received
substantially within the bore of said body when said sleeve is
moved to a position substantially outside said body and to be
extended from said body when said sleeve is received substantially
within said body;
e. a continuous, thin, flexible membrane connecting all of said
fingers;
f. a cord having a noose portion connected to the outer ends of
said fingers and a terminal portion extending through the bore in
said body; and
g. a windlass assembly carried by the outer end of said guide rod
and connected to the terminal end of said cord for tightening said
cord to secure said fingers to said head of said fetus.
8. In the apparatus of claim 7 wherein said guide rod is provided
with a bore therethrough for evacuating the space between said
membrane and said head of said fetus.
9. In the apparatus of claim 7 wherein said sleeve is provided with
a plurality of elongated slots and said body is connected to said
guide rod by means of spacer blocks slidably received in said slots
in said sleeve.
10. In the apparatus of claim 7 wherein the end of said guide rod
adjacent said fingers is provided with an outwardly flaring
surface.
11. In the apparatus of claim 7 wherein one of said fingers is
provided with a bore therethrough which receives a part of said
terminal portion of said cord.
Description
BACKGROUND OF THE INVENTION
1. Field of the Invention
This invention relates, in general, to a method and apparatus for
assisting in the delivery of a fetus from a womb.
2. Description of the Prior Art
Obstetrical delivery forceps currently in use for assisting in the
delivery of a fetus from a womb, particularly a human fetus, have
changed little since their inception. These forceps are rigid,
metallic devices which require insertion into the vagina and
contacting directly the head of the fetus with rigid metal
surfaces. One of the primary disadvantages of the presently used
forceps is that they are capable of applying intense pressure over
a very small area on both sides of the head of the fetus and only
in one direction. Unless the physician is extremely careful,
excessive pressure can be applied to the areas of the child's head
in contact with the forceps resulting in some type of injury to the
brain of the child, also eyes, ears, facial nerves, etc. Due to the
sharp edges of the current forceps, if the physician is not
extremely careful, he may cause damage to the soft tissues of the
mother's pelvis.
While some efforts have been made to develop new methods and
apparatuses for assisting in the delivery of a fetus from a womb,
no significant practical acceptance by obstetricians of the new
techniques or apparatuses has taken place. U.S. Pat. No. 1,782,814
discloses a flexible envelope structure adapted to be placed over
the head of a fetus. Due to the flexible construction, it would be
very difficult to position the device around the foetal head while
the fetus is still within the womb. A vacuum-assist, obstetrical,
caplike device is disclosed in U. S. Pat. No. 2,194,989. The thick
walls of this device would appear to prevent its collapse to a size
permitting insertion into the vagina to surround the foetal head. A
cervical dilator with expandable arms is disclosed in U. S. Pat.
No. 3,312,222. The arms are adapted to dilate the cervical opening
to assist in the delivery of the fetus. In U. S. Pat. No. 3,592,198
there is described an apparatus wherein a flexible plastic envelope
is molded to the contour of the foetal head, rigidified by
circulating a coolant therethrough, and then used to apply a pull
to the fetus to assist in delivery. While the apparatus represents
an advance over the formerly used metal forceps, the apparatus
required is complicated and expensive and also requires the use of
a high degree of skill in placing the device on the head of the
fetus and controlling its shaping to the foetal head.
Therefore, it can be seen that there is a need in the medical field
for a new method and apparatus for assisting in the delivery of a
fetus from a womb which will provide a simple apparatus that does
not require much skill to apply and will not cause injury to the
head of the fetus or injury to the soft tissues of the mother's
pelvis.
SUMMARY OF THE INVENTION
It is an object of the present invention to provide a method and
apparatus for assisting in the delivery of a fetus from a womb.
It is a further object of the present invention to provide an
apparatus for assisting in the delivery of a fetus from a womb
which is relatively simple to construct and to operate.
It is also an object of the present invention to provide an
apparatus for assisting in the delivery of a fetus from a womb
wherein a secure hold can be obtained upon the head of the fetus
without damaging any foetal parts.
It is still another object of the present invention to provide an
apparatus for delivering a fetus from a womb which can be
sterilized and reused or discarded.
It is a still further object of the present invention to provide an
apparatus for delivery of a fetus from a womb wherein the amount of
pressure applied to the head of the fetus can be carefully
controlled to prevent damage to the foetal parts.
The foregoing objects are realized in a method for assisting in the
delivery of a fetus from a womb comprising surrounding the upper
portion of the head of a fetus with a plurality of conforming,
resilient fingers; securing the fingers tightly to the head of the
fetus; and applying a limited pulling force to the fingers to
assist in the delivery of the fetus from the womb.
The apparatus aspects of the present invention are realized in an
apparatus which includes means to retain a plurality of flexible
fingers in a collapsed state, means to extend the fingers to
surround the head of the fetus, and means to secure the fingers to
the head of the fetus.
The method and apparatus of the present invention overcome many of
the disadvantages found in obstetrical forceps used heretofore to
assist in the delivery of a fetus from a womb. The present method
insures that a uniform, evenly distributed pressure is applied to
the head of the fetus, thus, obviating the dangers of localized
high pressure and subsequent damage of the child's brain.
Additionally, the apparatus of the present invention is adapted to
be securely attached to the head of the fetus through remotely
controlled means whereby even and uniform pressure is applied to
the head of the fetus.
BRIEF DESCRIPTION OF THE DRAWINGS
FIG. 1 is a perspective, isometric, elevational view of the
reproductive portion of a human female showing a fetus in position
with the apparatus of the present invention secured to the head of
the fetus;
FIG. 2 is a perspective, elevational, partially broken and
sectional view of the obstetrical delivery apparatus of the present
invention;
FIG. 3 is an elevational view of the obstetrical delivery apparatus
of the present invention;
FIG. 4 is an elevational view, partially in section, of the
obstetrical delivery apparatus of the present invention having the
fingers in the extended position;
FIG. 5 is an elevational view similar to FIG. 4 showing the
flexible fingers in the retracted position;
FIG. 6 is a cross-sectional view taken along line 6--6 of FIG.
3;
FIG. 7 is a cross-sectional view taken along line 7--7 of FIG.
3;
FIG. 8 is an enlarged, cross-sectional view of the portion of the
apparatus of the present invention showing the flexible finger
carrying the retractor cord;
FIG. 9 is an enlarged, sectional view taken along line 9--9 of FIG.
6; and
FIG. 10 is an enlarged, elevational view of the upper end of one of
the fingers of the apparatus of the present invention.
DESCRIPTION OF THE PREFERRED EMBODIMENTS
Referring now to FIG. 1, there is depicted a human female,
designated generally 15, in the position normally assumed during
childbirth. The fetus or child, designated generally 16, is
positioned in the uterus or womb 17 with its head 18 in the
normally downwardly directed position. The obstetrical delivery
apparatus of the present invention, designated generally 19, is
held in the left hand 20 of the physician, and the right hand 21 is
used to operate the device after placement of the apparatus within
the womb opening.
Referring now to FIGS. 2-5, the delivery apparatus 19 includes an
elongated, hollow support body or housing 22. The housing is hollow
and provides an elongated bore 23 which extends therethrough. The
lower end of the housing 22a abuts U clamp spacer 27. The housing
22 is slidably received over sleeve member 26. The lower end 26a of
the sleeve is received in a recess 24 provided in the head member
25. The lower end 26a of the sleeve is fixedly retained in the
recess 24 provided in the head member by means of silver solder or
other suitable means. U clamp spacer 27 which is attached by bolts
28 to sleeve member 26 can be removed, if desired, to provide a
greater extension of flexible fingers. A pair of handles 30--30 are
attached to the head member 25 by having their inner ends 31--31
threadably received in threaded bores 32--32 provided in opposite
sides of the head member.
As seen in FIGS. 2, 4, 5, 8 and 9, the sleeve 26 is generally
cylindrical and makes a close sliding fit within the bore 23 of the
housing 22. The upper end 26b of the sleeve provides a cylindrical
bore 33 extending therethrough. As seen more clearly in FIG. 2, the
sidewalls of the sleeve 26 are provided with opposed, longitudinal
slots 34--34.
A guide rod 35 is axially received within the bore 33 of the upper
end 26b of the cylindrical sleeve 26. O rings (not shown) may be
provided to insure a good vacuum seal between the upper end of
guide rod 35 and the thickened upper end portion 26b of the sleeve
26, if desired. The upper terminal portion 35a of guide rod 35 has
a larger diameter than the intermediate portion and is provided
with an outwardly flared tip portion 36 which extends above the end
of the housing or body 22. The lower end 35b of the guide rod 35 is
threaded and received in a threaded bore 37 provided in one end of
the vacuum control block 38, as seen in FIG. 7. The guide rod 35 is
provided with an axial bore 39 which extends from the vacuum
control block 38 to the opening in its upper tip portion 36.
Housing 22 is fixedly connected to guide rod 35 by means of pins
40--40 which pass through an opening provided in slide blocks
41--41 which are received in the slots 34--34 provided in the
sleeve 26.
The upper end 26b of sleeve 26 has attached thereto a plurality of
preset, arcuate-shaped, flexible, metal or plastic fingers or
spring members 42. These fingers are interconnected by means of a
thin, flexible, collapsible member 43 which is made from rubber or
plastic or other suitable material. The outer end of each of the
fingers or spring members 42 is provided with a transverse opening
44 therein, as can be more clearly seen in FIG. 10. A cord 45
passes through each of the openings 44 in the fingers to connect
all of the fingers together at their outer ends. One end of the
cord is secured to finger 42a, as seen in FIG. 2, and the other end
of the cord passes through a channel or opening 46 which is
provided within the hollow finger 42a. As can be seen more clearly
in FIGS. 8 and 9, the sleeve 26 is provided with a longitudinal
slot 47 which provides a passageway for the lower end 45a of the
cord 45. The lower end 45a of the cord passes through an opening
provided in the head member 25 and is attached to take-up reel 48
which is positioned within a slot 49 provided in head member 25.
Take-up reel 48 is fixedly mounted on rotatable shaft 50 positioned
in transverse openings provided in the body 25. Cord 45a can be
wound on the reel by rotating thumb screw 51 attached to the outer
end of shaft 50. A ratchet mechanism, designated generally by the
numeral 52, is provided on the other end of shaft 50 and locks the
reel 48 against unwinding. Ratchet mechanism 52 includes a toothed
wheel 53 which is fixed to the end of shaft 50 opposite thumb screw
51 and is received in a bore 54 provided in the side of head member
25. An elongated locking key 55 is slidably received in a bore
which extends through head member 25 and intersects the bore 54
provided on the side thereof. The locking key contains a detent arm
(not shown) which engages the toothed wheel 53 to prevent
counterclockwise rotation of the cord take-up reel 48 until the
outer end 56 of the locking key 55 is depressed. Spring 57 is
received in an enlarged portion of the bore extending through the
head 25 which carries locking key 55. This spring abuts a collar 58
which is an integral part of the rod 55 and urges the rod 55 toward
the outer end 56 in normal operation. The collar 58 is retained
against outward movement within the bore by means of a hollow
locking screw 59 which is threadably received in the bore carrying
the key 55.
Referring now to FIG. 7, the vacuum control block, designated
generally by the numeral 38, is provided with a series of valves
and channels for applying vacuum to the space between the fetus's
head 18 and the finger-supported membrane 43 by means of the bore
39 provided in the guide rod 35. An axial extension bore 60 is
provided in the block 38 which connects to the bore 39 provided in
guide rod 35. Axial bore 60 is intersected by transverse bore 61
which extends through the body 38 and is sealed by means of cap
screws 62--62 at each end thereof. A bore 63 and an offset recess
64 are provided in the block 38 and contain a vacuum check valve
which includes the valve seat 65, check valve ball 66, compression
spring 67 and vacuum plug 68. Plug 68 is threadably received in a
threaded portion of the recess 64 and is provided with a central
cylindrical extension 69 to which may be attached a hypodermic
syringe 70 shown in dotted outline in FIG. 7. A bore 71 connects
the vacuum recess 64 to the exhaust recess 72. The exhaust recess
contains an exhaust check valve which includes a seat 73, check
valve ball 74, retainer spring 75 and exhaust plug 76. The lower
end 35b of guide rod 35 is retained in the block 25 by means of a
set screw 77 received in a threaded bore 78.
In utilizing the apparatus of the present invention to assist in
childbirth, the physician first places the instrument in the
position shown in FIG. 5 of the drawings, that is, the head member
25 is moved rearwardly to the position where its lower face is in
abutment with the upper face of the vacuum block 38. In this
position the fingers 42 are retracted within the housing 22 and are
placed in a generally parallel position within the cavity provided
between the housing 22 and the guide rod 35. The physician holds
the instrument in his left hand, as seen in FIG. 1, and places the
outer tip portion 36 of the instrument against the crown of the
head of the fetus through the vaginal opening. With his right hand,
the physician then grasps one of the handles 30 while holding the
tip 36 firmly in position against the fetus's head. He then moves
the sleeve 26 forward in housing 22 by pushing forward on handle 30
until the flexible fingers 42 are moved forward out of the space
between the body 22 and guide rod 35 and assume the position shown
in FIG. 1 surrounding the head of the fetus. The physician tightens
the noose portion of the cord 45 by rotating the thumb wheel 51 of
the cord take-up mechanism to lock the tips of the flexible fingers
42 securely to the head of the fetus and then pumps the plunger of
the hypodermic syringe 70 a sufficient number of strokes to create
a vacuum between the membrane 43 and the head of the fetus to
securely bind the membrane to the head of the fetus. Having
securely attached the apparatus to the head of the fetus, the
physician then pulls back on the handles 30--30 of the apparatus
with the proper force to assist in the delivery of the fetus from
the womb. After delivery has progressed to the point where the head
of the fetus is outside of the mother's body, the apparatus may be
removed from the head of the fetus by depressing the tip 56 of rod
55 of the ratchet mechanism thereby releasing the cord tension and
relieving the vacuum by turning the thumb screw 80, thus permitting
the fingers to be retracted back into the apparatus by pulling back
on the handles 30--30 and retracting the fingers to the position
shown in FIG. 5. Slots 79 in the tip 36 of the guide rod facilitate
applying and releasing vacuum between the fetus's head and the
membrane 43.
The delivery apparatus of the present invention can be conveniently
fabricated from stainless steel or other metals which are
corrosion-resistant and capable of sterilization and reuse.
However, the apparatus may be formed in part or substantially
completely from plastic parts whereby the apparatus may be used one
time and discarded. If the apparatus is constructed from steel or
stainless steel or other metals, it may be disassembled for
cleaning and autoclaving and subsequently reused.
While there has been described what is the preferred embodiment of
the present invention, it will be obvious to those skilled in the
art that various modifications can be made thereto which are still
within the scope of the invention. For example, an automatic vacuum
relief valve may be provided in the vacuum control block 38 at one
end of bore 61 whereby the vacuum may be limited to a preset
maximum value to automatically limit to a predetermined value the
total force or pull applied to the fetus. When operated in this
manner, the noose portion of the cord 45 would not be tightened.
Other modifications will be obvious to those skilled in the art.
The invention is to be limited only by the scope of the following
claims.
* * * * *