Feasibility Study to Evaluate the Role of a Novel Device in Childbirth

Accidentally retained surgical items or swabs are well-recognised errors that result in adverse consequences for patients. This error is one of the commonest "Never Events" - patient safety incidents that are considered preventable. Although uncommon, these incidents can have devastating consequences. Retained surgical items have 70% re-interventions, reaching 80% morbidity and 35% mortality.

Swabs or sponges are like small towels that soak up blood and body fluids so that the surgeon can visualise the operating area effectively. Swabs are used in all areas of surgery which include operations on the tummy, chest, limbs. They are also used in the vagina during childbirth, to assess for tears and to minimise blood oozing from the vagina.

The common risk factors for this error are out of hours surgical or childbirth procedures, multiple handovers in the care of the patient, raised BMI (Body Mass Index) and unplanned change to the operative intervention.

As the name suggests, a 'never event' should never happen in the first place. Never. Unfortunately, this is not the case. Incidents involving surgical swabs being left behind, particularly during a caesarean section or a perineal repair following a vaginal birth, are still happening despite over 100 years of institutional awareness of the problem and tentative solutions being implemented in clinical practice.

never-event incidents involving retained surgical swabs are a widespread problem affecting healthcare systems worldwide. It is therefore reasonable to ask the question: why are surgical swabs being left behind and what can be done to prevent this from happening?

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Key information

Conditions

Surgical Item, Retained Childbirth Foreign Bodies Wounds and Injuries

Age range

18 year and older

Sex eligibility

Female

Study type

Observational

Who can participate

Healthy volunteers accepted: Yes

Only the study team can determine whether someone qualifies for participation.

Inclusion criteria

Midwifery lead and consultant lead patient older than 18 years.
Consented to participation after an informed choice.

Exclusion criteria

Under 18 years of age

Antenatal (before labour):

Patients who have a high risk of expected/unexpected maternal, fetal or neonatal deterioration such that during birth, the focus of attention would be towards safe patient care and observation required for using the swab-counter device system would not be possible such as :
Patients who are seriously unwell and require high dependency care.
Maternal cardiac conditions
Severe pre-eclampsia
Fetal anomalies where neonatal deterioration is expected (These will be relatively rare conditions where the doctor/midwife would decide to not recruit the patient)

Intrapartum and postpartum factors:

Patient having an emergency Caesarean section instead of a vaginal birth due to maternal or fetal indication.
Eclampsia (seizure/fitting in labour or after delivery)
Maternal cardiac conditions requiring high dependency care
Severe sepsis requiring high dependency care
Fetal anomalies where neonatal deterioration is expected

Treatment and study plan

iCount system assembled with swabs

Device

Designed as single use. Intended purpose - To be used to count swabs and tampons after childbirth in an objective manner. This is intended to be used in women during and after childbirth.

Primary outcomes

Rate of device count accuracy (conspicuity of spotting a missing swab) measured via staff questionnaire feedback

Time frame: 12 months
User experience about general look and feel and user satisfaction (overall perception) measured via staff questionnaire feedback

Time frame: 12 months
User perception about the confidence about the accuracy of the count with use of the device and thoughts about intention to use, if available (functionality) measured via staff questionnaire feedback

Time frame: 12 months
User perception about the ease of learning of how to use the device measured via staff questionnaire feedback

Time frame: 12 months
User perception of how device works within current system measured via staff questionnaire feedback

Time frame: 12 months

Study contacts

Contact information is provided by the study sponsor or research team.

Aditi Desai

CONTACT

[email protected]

01902695166

Sponsors and collaborators

Lead sponsor

The Royal Wolverhampton Hospitals NHS Trust

Other Gov

Registry information

Official study title

Feasibility Study to Evaluate the Role of a Novel Device in the Prevention of Retained Items In Childbirth Environment- Clinical Usability Pilot Study

Acronym: PRINCE

Important dates

Study start: 2026
Primary completion: 2027
Study completion: 2027
First posted: May 13, 2022
Registry last updated: Apr 9, 2026

OpenTrials presents study information sourced from ClinicalTrials.gov. The official registry record should be consulted for the latest information.

View the official ClinicalTrials.gov record (opens in a new tab)

This listing is for discovery and informational purposes only. It is not medical advice, does not guarantee that a study is recruiting, and does not determine eligibility. Contact the study team and a qualified healthcare professional when considering participation.

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