Ventouse delivery in a low

resource setting - An

innovative device Dr Tanya Robbins / Mr Arfang Faye

Maternal and Child Health Advocacy International (MCAI)

Millennium Development Goals

� MDG 4: reduce child mortality

� MDG 5: improve maternal health

� MDG 8: develop a global partnership for global

development

Background

� 3 million neonatal deaths in 2011 (WHO)

� 25-45% of all neonatal deaths occur in the first 24 hours of life

� Up to 2/3 of neonatal deaths could be prevented if skilled health workers provide effective measures at birth and

during the first week of life

� Instrumental vaginal delivery is a key component of

essential emergency obstetric care

� Requires skilled attendant as well as appropriate

equipment

� Forceps vs vacuum extraction

EgAr Device

EgAR device

� Developed at Bansang Hospital, The Gambia in 2012 by

Arfang Faye, a registered midwife

� Developed in response to urgent need for a vacuum

delivery device following damage to standard suction machine

� Made from locally sourced materials available within the

hospital (excluding the pressure gauge)

Components

� 60 ml or 100ml plastic syringe

� 2 outflow control valves from urinary catheter

� Tubing from a damaged stethoscope

� 2 one-way valves from damaged manual sphygmomanometer

SILASTIC VACUUM CUPSTETHOSCOPE TUBE

100 ML

PLASTIC

SYRINGE

GAUGE

VACUUM RELEASE VALVE

(from urine bag outflow control unit)

ONE WAY ANEROID BLOOD PRESSURE

VALVES

� Can be used with silastic or metal cups

� 2-3 pulls on the syringe creates enough pressure to create a vacuum suitable for delivery of the baby without the

need for continuous pumping (0.8kg/cm2)

� Release valve allows quick release of pressure once head is

delivered

� The EgAr Device was tested at Bansang Hospital from July

to November 2012

� 24 vacuum deliveries were performed using the device

� 22 were successful vaginal deliveries

� Pressure gauge was not available at this point to measure

the pressure exerted on the fetal head

� No cases of significant trauma to fetal head were reported

� From July 2012 the EgAr Device has been the sole device

used for vacuum deliveries in Bansang

� More recently the device has been developed for use as

suctioning of secretions in neonates

Advantages

� Inexpensive

� Readily available materials

� Effective and easy to use

� Easy to clean and sterilize

� Durable

� The EgAr Device has the potential to be extremely useful

in a range of low resource settings both as a suction device and for vacuum deliveries as well as potential to create

positive pressure

SYRINGE OF EgAr DEVICE ONE WAY VALVES OF EgAr DEVICE

SUCTION

TUBE

100 ML PLASTIC LAB. SPECIMEN BOTTLE

Thank you