Computational modeling of vacuum-assisted delivery: biomechanics of maternal soft tissues.

IF 3 3区 医学 Q2 BIOPHYSICS
Rita Moura, Dulce A Oliveira, Nina Kimmich, Renato M Natal Jorge, Marco P L Parente
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Abstract

Childbirth is a complex process influenced by physiological, mechanical, and hormonal factors. While natural vaginal delivery is the safest, it is not always feasible due to diverse circumstances. In such cases, assisted delivery techniques, such as vacuum-assisted delivery (VAD), may facilitate vaginal birth. However, this technique can be associated with a higher risk of maternal injuries, potentially resulting in long-term conditions such as pelvic organ prolapse or incontinence. This study investigates the biomechanical impact of VAD on maternal tissues, aiming to reduce these risks. A finite element model was developed to simulate VAD, incorporating maternal musculature, a deformable fetal head, and a vacuum cup. Twelve simulations were conducted, varying contraction durations, resting intervals, and the number of pulls required for fetal extraction. Results revealed that prolonged contraction durations, coupled with extended resting intervals, lead to a reduction in pelvic floor stress. Elevated stress levels were observed when fetal extraction involved two pulls, with an 8.43% decrease in maximum stress from two pulls to four. The peak stress recorded was 0.81 MPa during a 60-second contraction, followed by a 60-second rest period. These findings indicate that longer maneuvers may reduce trauma, as extended pulls allow muscles more time to relax and recover during both contraction and rest phases. Furthermore, an increased number of pulls extends the duration of the maneuver, facilitating fetal rotation and improved adjustment to the birth canal. This study offers crucial insights into the biomechanics of childbirth, providing clinicians with valuable information to enhance maternal outcomes and refine assisted delivery techniques.

真空辅助分娩的计算模型:母体软组织的生物力学。
分娩是一个复杂的过程,受生理、机械和激素因素的影响。虽然自然阴道分娩是最安全的,但由于情况不同,并不总是可行的。在这种情况下,辅助分娩技术,如真空辅助分娩(VAD),可以促进阴道分娩。然而,这种技术可能会增加产妇受伤的风险,可能导致盆腔器官脱垂或尿失禁等长期疾病。本研究旨在探讨VAD对母体组织的生物力学影响,以降低这些风险。建立了一个有限元模型来模拟VAD,该模型包含母体肌肉组织、可变形的胎儿头部和一个真空杯。进行了12次模拟,不同的收缩持续时间,休息间隔,以及胎儿提取所需的牵拉次数。结果显示,延长的收缩持续时间,加上延长的休息间隔,导致盆底压力的减少。当胎儿抽取两次时,观察到压力水平升高,最大压力从两次减少到四次,减少了8.43%。在60秒的收缩期间,记录到的峰值应力为0.81 MPa,然后是60秒的休息时间。这些发现表明,长时间的拉伸可以减少创伤,因为长时间的拉伸可以让肌肉在收缩和休息阶段有更多的时间放松和恢复。此外,增加的牵拉次数延长了操作的持续时间,促进胎儿旋转和改善对产道的调整。这项研究为分娩的生物力学提供了重要的见解,为临床医生提供了有价值的信息,以提高产妇的结局和完善辅助分娩技术。
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来源期刊
Biomechanics and Modeling in Mechanobiology
Biomechanics and Modeling in Mechanobiology 工程技术-工程:生物医学
CiteScore
7.10
自引率
8.60%
发文量
119
审稿时长
6 months
期刊介绍: Mechanics regulates biological processes at the molecular, cellular, tissue, organ, and organism levels. A goal of this journal is to promote basic and applied research that integrates the expanding knowledge-bases in the allied fields of biomechanics and mechanobiology. Approaches may be experimental, theoretical, or computational; they may address phenomena at the nano, micro, or macrolevels. Of particular interest are investigations that (1) quantify the mechanical environment in which cells and matrix function in health, disease, or injury, (2) identify and quantify mechanosensitive responses and their mechanisms, (3) detail inter-relations between mechanics and biological processes such as growth, remodeling, adaptation, and repair, and (4) report discoveries that advance therapeutic and diagnostic procedures. Especially encouraged are analytical and computational models based on solid mechanics, fluid mechanics, or thermomechanics, and their interactions; also encouraged are reports of new experimental methods that expand measurement capabilities and new mathematical methods that facilitate analysis.
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