1. BME 273 Fetal Stabilizer for Intrauterine Surgery Michael Dinh Advisor: Dr. Joseph Bruner

2. Spina Bifida One of the most common debilitating neural tube defect One of the most common debilitating neural tube defect Incomplete closure in the spinal column usually in the lower section during initial pregnancy.Incomplete closure in the spinal column usually in the lower section during initial pregnancy. Spina Bifida affects approximately 1 out of every 1,000 newborns in the U.S Spina Bifida affects approximately 1 out of every 1,000 newborns in the U.S

3. Degree of Spina Bifida Spina Bifida Occulta Spina Bifida Occulta Spina bifida occulta is a small gap in one or more of the vertebrae. This is the mildest form of spina bifida as there is no apparent damage to the spinal cord.Spina bifida occulta is a small gap in one or more of the vertebrae. This is the mildest form of spina bifida as there is no apparent damage to the spinal cord. Meningocele Meningocele Meninge (protective layer covering the spinal cord) protrudes through the gap in the spinal column in a form of a sac. The spinal cord itself remains intact and repairs can be made with little or no damage. Least common occuring form.Meninge (protective layer covering the spinal cord) protrudes through the gap in the spinal column in a form of a sac. The spinal cord itself remains intact and repairs can be made with little or no damage. Least common occuring form. Mylemeningocele Mylemeningocele Most severe form. This term is generally used interchangeably with spina bifida. Spinal cord itself protrudes through the gap in the spinal column.Most severe form. This term is generally used interchangeably with spina bifida. Spinal cord itself protrudes through the gap in the spinal column.

4. Spina Bifida Manifesta Protrusion of spinal cord membrane, spinal cord, and nerve roots Protrusion of spinal cord membrane, spinal cord, and nerve roots Spinal cord exposure result in progressive damage Spinal cord exposure result in progressive damage Most often found in the lumbo-sacral region Most often found in the lumbo-sacral region

5. Adverse Affect Hydrocephalus Hydrocephalus Accumulation of spinal fluid in brain is common among infants with spina bifidaAccumulation of spinal fluid in brain is common among infants with spina bifida Permanent weakness or paralysis in lower extremity below defect Permanent weakness or paralysis in lower extremity below defect Loss of bowel and bladder control due to the nerve damage Loss of bowel and bladder control due to the nerve damage

6. Vanderbilt University 165 cases of spina bifida repair 165 cases of spina bifida repair Age range of infants 19-30 weeksAge range of infants 19-30 weeks Mean operating time is about 87 min Mean operating time is about 87 min Ranges from 62-131 minRanges from 62-131 min

7. Design Objective Design a fetal stabilizer to assist in surgery Design a fetal stabilizer to assist in surgery Hold fetus steady while providing an opening for operation

8. Approach Observe open repair of spina bifida Observe open repair of spina bifida Collect fetal biometrical data Collect fetal biometrical data Look at similar device in handling fetus Look at similar device in handling fetus Simpson Forceps: Used in deliverySimpson Forceps: Used in delivery

9. Fetal Data 19 week old fetus 19 week old fetus 6 inches head to end6 inches head to end Weight about 8.5 ouncesWeight about 8.5 ounces Abdominal Circumference about 133 mmAbdominal Circumference about 133 mm Width about 60 mmWidth about 60 mm

10. Device Design Top ViewFront View Side View

11. Device Specification Overall Length: 20 cm Overall Length: 20 cm Depth of Paddle Arm: 6 cm Depth of Paddle Arm: 6 cm Width of Paddle Arm: 4 cm Width of Paddle Arm: 4 cm Width of device: 7.5 cm Width of device: 7.5 cm Space b/w Arm Center: 6 cm Space b/w Arm Center: 6 cm Space b/w Arm bottom: 5 cm Space b/w Arm bottom: 5 cm Width of opening: 5 cm Width of opening: 5 cm Length of opening: 7 cm Length of opening: 7 cm Side handle about 45 mm in length Side handle about 45 mm in length

12. Conclusion Design stabilizes fetus using forces present Design stabilizes fetus using forces present Contracting uterine wall force & fetal outward forceContracting uterine wall force & fetal outward force Facilitate in operation Facilitate in operation No need for retaining hooksNo need for retaining hooks Simple in use Simple in use Two piece deviceTwo piece device Varying degree of adjustability for variation in fetal sizeVarying degree of adjustability for variation in fetal size