The Tydeman tube: helping surgeons perform safer caesarean sections

Dr Annette Briley, Mr Paul Seed, Dr Graham Tydeman, Professor Andrew Shennan

Tommy’s is working with Guy’s and St Thomas’ Charity to find innovative solutions to the tricky problem of late caesarean sections.

Delivering a baby by caesarean can be more difficult if done in the late first or second stages of labour, instead of before or very early in labour. This can happen when a woman is intending to deliver her baby vaginally, but contractions of the womb aren’t enough to push the baby out. It can also happen if the baby is in an unsafe position and could harm itself or the mother during birth. A surgeon will then have to deliver the baby by caesarean.

This is difficult because the baby’s head will be much lower down, making it harder to get to. It is made even trickier because the contraction of the womb creates a partial vacuum between the mother, and the baby’s head. The contractions act like a suction cup to remove the air, meaning the baby’s head can get stuck. To deliver the baby, the surgeon must release this vacuum.

At the moment, this affects up to 50,000 women every year and makes it much harder for the surgeon to safely remove the baby. However, there isn’t a clear policy for what to do when this happens.

Tommy’s is working with the Guy’s and St Thomas’ Charity to change this. We have created a device called the Tydeman Tube that can be inserted into the vagina. Once there, it helps air to flow around the baby’s head, breaking the vacuum and releasing the baby.

This year, the results of early cases using the Tydeman Tube have been published, with positive results. A company, Clinical Innovations, are interested in developing the device and we are now hoping to receive funding to take this forward.

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This study takes place in a Tommy's centre and is funded by Tommy's and Guy's and St Thomas' Charity Innovations Stream

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