'Desperate Debra': making caesareans safer

A new caesarean simulator called Desperate Debra® is being launched by the Trust, in collaboration with NHS Fife and Adam,Rouilly Ltd.

Desperate Debra® is the first simulator used to train doctors in dealing with late-stage (emergency) caesareans, which affect around 20,000 births per year in the UK and can be life-threatening for both mother and baby.

Training for a dangerous situation

During emergency caesareans, the baby’s head may get stuck in the pelvis because the woman is in the advanced stages of labour.

As well as being life-threatening for both mother and child, there may be complications during the operation and in the long term.

“Emergency caesareans at full dilatation can be challenging and dangerous,” says Professor Andrew Shennan, Professor of Obstetrics and Deputy Director of Research and Development at the Trust, 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.”

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

Highly realistic

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

“Making Desperate Debra® was very technically challenging,” says Gabriel Ogwo from 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, a consultant in obstetrics and gynaecology at 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.”

Charity support

The innovation was supported from concept to the prototyping stage by Guy's and St Thomas' Charity Innovation Fund for Technology Transfer (GiFTT), which provides funding, and advice on intellectual property and finding commercial backing.

Dr Michael Wright, Commercial Manager at Guy’s and St Thomas’ Charity said: “Desperate Debra is a real exemplar for our GiFTT programme, which supports the early development of commercially-viable medical technologies that could transform patient care and enable healthcare staff do their jobs more effectively.”