Patent Publication Number: US-2022211343-A1

Title: Labor garment facilitating administration of an epidural and maintaining monitoring transducers in place

Description:
BACKGROUND OF THE INVENTION 
     Medical staff routinely monitor the progress of pregnant woman during labor and delivery with one or more transducers that report on the uterine contractions and the fetal heartbeat or fetal heart tones. To function properly these transducers need to be held in position during the progress of the labor to delivery, particularly when the patient is sitting up for epidural placement. They require a particular type of interface with the skin of the woman in labor, typically a gel that has been applied to a specific location. In addition, these transducers are typically calibrated based on their relative positions to the uterus of the woman. Adhesives and belts have been employed but are not entirely satisfactory. The adhesives are adversely affected by sweat developing on the skin of the woman and the belts have a tendency to slip, especially given the concern that they not be so tightly cinched as to cause undue discomfort to the woman in labor. Therefore, the practice has developed to use a garment, which looks like a band. that encompasses the torso of the woman covering her belly and the adjacent portion of her back to hold these transducers in place. This garment or band has been used to cover adhesives and belts. However, the mechanical configuration of such garments prevents easy access to the lower spine of the woman including the lumbar spine region between L 2  and S 1  that is important for the administration of epidural injection and placement of continuous labor epidural with a catheter. Thus, the garments or bands currently being used are not designed to accommodate for placement of an epidural. The current garment must be moved either up or way down to expose the lumbar spine for epidural administration. This movement of the garment adversely effects the reliability of the signal from the relevant transducer making it very difficult to monitor the fetal heart tones. From the time the patient is sitting up for an epidural to lying down is on average about 15 minutes. If the fetal heart tones cannot be monitored for that long, it puts the welfare of unborn baby in jeopardy. In addition, these garments or bands are not designed to provide dignified comfort and care to pregnant women. 
     SUMMARY OF THE INVENTION 
     The present invention involves a stretchable garment adapted to be worn by a woman in labor to hold one or more monitoring transducers in place during labor and delivery. It comprises a fabric body that encircles the torso of the woman including her belly and has an aperture which allows access to between L 2  and S 1  of her lumbar spine. The garment is designed to provide comfort and dignity to the new mom to be, as the parents welcome their new baby to the family. 
    
    
     
       BRIEF DESCRIPTION OF THE DRAWINGS 
         FIG. 1  is a perspective view of the back of a woman in labor seated wearing a labor garment. 
         FIG. 2  is a perspective view of the back of a woman in labor standing wearing a labor garment. 
         FIG. 3  is a profile perspective view of a woman in labor standing wearing a labor garment. 
         FIG. 4  is a profile perspective view of a woman in labor standing wearing a labor garment. 
         FIG. 5  is a perspective view of the back of a woman in labor lying on her side wearing a labor garment. 
         FIG. 6  is an expanded view indicated by line  6 - 6  of the woman and labor garment illustrated in  FIG. 5 . 
     
    
    
     DETAILED DESCRIPTION 
       FIG. 1  illustrates a labor garment  200  on the torso of a woman in labor  100  in a sitting position. Garment  200  has a top band  210  and a bottom band  220  which aid in affixing the garment  200  to the torso of the woman and retain it in its desired position. This garment  200  also has an aperture  230  which aligns with the lumbar spine of the woman  100  and provides easy access to the portion of her lumbar spine between L 2  and S 1 . This facilitates the administration of an epidural by an anesthesiologist without disturbing the positioning of the garment  200 . The garment  200  may be quite similar to that disclosed in U.S. Pat. No. 9,456,637 to Fligel of Garan, incorporated by reference herein, with a modification to provide an aperture  230 . It is desirable that the garment  200  be so designed that movement between it and the torso of the woman is minimized through the course of labor and delivery. 
       FIG. 2  illustrates that the garment  200  stays in position on the torso of the woman  100  when she is in a standing position with the aperture  230  aligned with the lumbar spine. In this regard it is desirable that placing the woman  100  in various positions during her labor and delivery process will not affect the position of the garment  200  on her torso. 
       FIG. 3  illustrates the garment  200  with a pouch  240  that accommodates the belly of the woman  100 . This configuration may be aided by having the distance between the top band  210  and the bottom band  220  be greater in the portion of the garment  200  that covers the belly of the woman  100  than in the portion that covers the remainder of the torso including the back of the woman  100  in the manner disclosed in U.S. Pat. No. 9,456,637. The garment  200  covers a transducer  300  that monitors either the labor contractions or the fetal hear beat or both in the manner of U.S. Pat. 4,966,152 to Gang et al. of Hewlett-Packard, incorporated by reference herein. This transducer  300  may simply lie beneath the garment  200  or it may be held in a pocket of the garment  200 . In the latter case the pocket needs to be configured to allow the transducer  300  to contact the skin of the woman  100 . The transducer  300  may be affixed to the skin of the woman  100  by an appropriate adhesive or it may simply contact this skin via an appropriate ultrasound transmitting gel. In either case the garment makes a significant contribution to retaining the transducer  300  in an appropriate location. Commonly the transducer  300  is position to receive an optimum signal representative of the fetal heart beat and is calibrated in accordance with its position. In this regard a particularly desirable location for the placement of a toco probe for simultaneous monitoring of the labor contractions and the fetal heart beat is adjacent to the umbilicus on the fondus of the uterus. Thus, obviating any need to move the garment  200  to administer an epidural to the lumbar spine by providing the aperture  230  facilitates obtaining an uninterrupted and reliable signal of the fetal heart beat while an epidural is administered. 
       FIG. 4  illustrates the same features as  FIG. 3  with the exception that it has a transducer  400  in a different location than the transducer  300  illustrated in  FIG. 3 . There are a variety of reasons why it might be advantageous to use more than one transducer to monitor labor contractions and the fetal heartbeat. Among others is the fact that as explained in U.S. Pat. No. 4,966,152 the optimum locations for a toco transducer to monitor the labor contractions may differ from the transducer for monitoring the fetal heartbeat. 
       FIG. 5  illustrates the woman  100  lying on her side. with her back facing the viewer. It displays the same features as  FIG. 2 . The aperture  230  provides easy access to the lumbar spine between L 2  and S 1  so that an epidural could be administered without any need to move the garment  200  and any transducer that it may be holding in place. 
       FIG. 6  is an expanded view defined by lines  6 - 6  of  FIG. 5  of the lumbar spine region  110  of the woman  100  with the garment  200  and its aperture  230  properly placed to facilitate the administration of an epidural. 
     The garment  200  may have any number of designs and may be made of a wide variety of materials. It is conveniently stretchable so it can be readily slipped over the torso of a woman  100  either starting from either the head or the feet. It is advantageous if it applies enough elastic force to the torso of the woman  100  that it is able to hold one or more transducers in place and maintain its aperture  230  over the appropriate portion of the lumbar spine throughout the course of labor and delivery without causing undue discomfort to the woman  100 . A design which has a pouch for encompassing the belly of the woman in labor  100  such as that disclosed in U.S. Pat. No. 9,456,637 is convenient as is constructing the garment  200  with soft fibers, at least some of which are elastic. 
     The garment  200  may be applied to the woman in labor  100  after she arrives at the birthing hospital and advantageously after any desired monitoring transducers  300  and  400  and associated ultrasound transmission gels have been applied to their desired locations. If the garment is to be applied to a woman  100  in active labor, it may be convenient to provide a break in the garment  200  so that it can be wrapped about the woman  100  instead of being slipped over her torso. In such a case the garment  200  would be provided with fastening means such as snaps, clips, a zipper or Velcro strips to close the break. 
     The garment  200  could be supplied to the woman  100  in advance of her presenting at the birthing hospital. This would allow her to don it when her labor was less active so that the slipping on of the garment  200  would involve less discomfort. 
     It is desirable that the garment  200  stays in position on the torso of the woman  100  regardless of whether she is in a standing, sitting or lateral position with the aperture  230  aligned with the lumbar spine. 
     While only certain features of the invention have been illustrated and described herein, many modifications and changes will occur to those skilled in the art. It is, therefore, to be understood that the appended claims are intended to cover all such modifications and changes as fall within the true spirit of the invention.