Reliability and educational potential of a computational model of vacuum-assisted delivery on a birth simulator

IF 1.4 3区医学 Q4 ENGINEERING, BIOMEDICAL

Clinical Biomechanics Pub Date : 2025-07-24 DOI:10.1016/j.clinbiomech.2025.106633

Y. Vallet , J. Lefebvre , C. Bertholdt , A. Baldit , R. Rahouadj , O. Morel , C. Laurent

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引用次数: 0

Abstract

Background

Vacuum-assisted delivery is widely used in operative vaginal deliveries but carries a risk of rare yet severe complications. Computational simulations offer a promising way to improve our understanding of the mechanisms underlying these injuries. However, these simulations remain insufficiently validated experimentally and have not yet been applied to vacuum extraction. This study aims to evaluate the reliability of these methods using a simplified training dummy and to demonstrate their educational potential by analyzing key parameters of the clinical procedure.

Methods

Reliability was assessed using a birth simulator by comparing predicted extraction forces (derived from computational simulations using the finite element method) with experimental measurements obtained from vacuum extractions performed using a Kiwi® cup on a training dummy mounted on a force platform (N = 16). The model was then used to investigate how prescribed trajectory, suction cup position, and fetal head size influence both extraction forces and maximum strain in external deformable tissues.

Findings

The maximal extraction force predicted by computational simulations was 42.3 N, while it ranged between 46.1 N and 85.3 N (mean 67.5 ± 13.3 N, N = 16) experimentally. Similar trends in the force components were obtained through the whole extraction trajectory. The most downward trajectory was shown to minimize extraction force and maximal perineal tissue strain, as well as achieving the most occipital cup placement, in line with reported recommendations.

Interpretation

Results demonstrated that computational simulations could reliably predict extraction forces during birth simulations on a training dummy, while also revealing associated uncertainties and a tendency to underestimate extraction forces. Simulations of various scenarios provided valuable insights that could enhance obstetrics training and complement existing methods. Although not intended for direct clinical translation, this study evaluates the relevance of computational modelling in a controlled, simulation-based training context.

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生产模拟器上真空辅助分娩计算模型的可靠性和教育潜力

背景：真空辅助分娩广泛应用于阴道手术分娩，但存在罕见但严重并发症的风险。计算模拟提供了一种很有希望的方法来提高我们对这些损伤机制的理解。然而，这些模拟仍然没有得到充分的实验验证，尚未应用于真空抽提。本研究旨在利用简化的训练假人来评估这些方法的可靠性，并通过分析临床程序的关键参数来展示它们的教育潜力。方法使用出生模拟器，通过比较预测的拔牙力（采用有限元法计算模拟得出）与安装在力平台上的训练假人（N = 16）上使用Kiwi®杯进行的真空拔牙实验测量结果，来评估可靠性。然后用该模型研究了规定的轨迹、吸盘位置和胎儿头部大小如何影响体外变形组织的拔牙力和最大应变。结果计算模拟预测的最大拔牙力为42.3 N，而实验结果为46.1 ~ 85.3 N（平均67.5±13.3 N, N = 16）。在整个抽拔轨迹中得到了相似的力分量变化趋势。最向下的轨迹显示出最小的拔牙力和最大的会阴组织张力，以及实现最大的枕杯放置，与报道的建议一致。解释结果表明，在训练假人的出生模拟中，计算模拟可以可靠地预测提取力，同时也揭示了相关的不确定性和低估提取力的倾向。各种场景的模拟提供了有价值的见解，可以加强产科培训和补充现有的方法。虽然不打算直接用于临床翻译，但本研究评估了计算模型在受控的、基于模拟的培训环境中的相关性。

本文章由计算机程序翻译，如有差异，请以英文原文为准。

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来源期刊

Clinical Biomechanics 医学-工程：生物医学

CiteScore

3.30

自引率

5.60%

发文量

189

审稿时长

12.3 weeks

期刊介绍： Clinical Biomechanics is an international multidisciplinary journal of biomechanics with a focus on medical and clinical applications of new knowledge in the field. The science of biomechanics helps explain the causes of cell, tissue, organ and body system disorders, and supports clinicians in the diagnosis, prognosis and evaluation of treatment methods and technologies. Clinical Biomechanics aims to strengthen the links between laboratory and clinic by publishing cutting-edge biomechanics research which helps to explain the causes of injury and disease, and which provides evidence contributing to improved clinical management. A rigorous peer review system is employed and every attempt is made to process and publish top-quality papers promptly. Clinical Biomechanics explores all facets of body system, organ, tissue and cell biomechanics, with an emphasis on medical and clinical applications of the basic science aspects. The role of basic science is therefore recognized in a medical or clinical context. The readership of the journal closely reflects its multi-disciplinary contents, being a balance of scientists, engineers and clinicians. The contents are in the form of research papers, brief reports, review papers and correspondence, whilst special interest issues and supplements are published from time to time. Disciplines covered include biomechanics and mechanobiology at all scales, bioengineering and use of tissue engineering and biomaterials for clinical applications, biophysics, as well as biomechanical aspects of medical robotics, ergonomics, physical and occupational therapeutics and rehabilitation.