Rita Moura, Dulce A Oliveira, Nina Kimmich, Renato M Natal Jorge, Marco P L Parente
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引用次数: 0
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.
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.