Effect of different labor forces on fetal skull molding
Effect of different labor forces on fetal skull molding
复制标题
不同劳动力对胎儿颅骨成型的影响
DOI：
10.1016/j.medengphy.2010.12.018
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发表时间：
2011-06-01
影响因子：
2.2
通讯作者：
Fan, Yubo
中科院分区：
文献类型：
--
作者：
Pu, Fang;Xu, Liqiang;Fan, Yubo
在阴道分娩过程中，胎头成型对使胎头适应产道非常重要；然而，胎头过度变形可能导致严重的并发症。劳动力是造成胎头变形的主要因素之一，但对其对胎头成型的影响尚未有定量研究。我们通过使用有限元建模方法来检验这种影响。首先，利用白光三维扫描仪对聚乙烯胎儿颅骨模型进行扫描，建立几何模型；其次，在几何模型的基础上建立了非线性有限元模型；然后，将模型的仿真结果与其他文献报道的实验数据进行对比验证，结果与实验观测结果吻合较好。在此基础上，利用该模型模拟了不同劳动力条件下胎儿颅骨的变形。仿真结果表明，随着劳动力的增加，胎儿颅骨直径和改良成型指数（MMI）均有所增加。冠状缝周围的顶骨和额骨承受更大的应力，冠状缝周围的顶骨和额骨在更大的劳动力下承受更大的空间和旋转位移。枕下颅骨直径（SOBD）比其他胎儿颅骨直径对产力的变化更为敏感。模拟结果揭示了分娩过程中劳动力与胎儿颅骨成型之间的定量关系。未来，如果胎儿颅骨成型程度与颅脑损伤程度直接相关，本研究的关系可用于通过测量分娩时的劳动力来预测颅脑损伤。(c) 2011年项目。Elsevier Ltd.出版。版权所有。
Fetal head molding is important for adapting the fetal head to the birth canal during vaginal delivery; however, excessive deformation of fetal head may lead to severe complications. Although labor force is one of the major factors which cause deformation of the fetal head, its effect on fetal head molding has not been quantitatively investigated yet. We examined this effect by using a finite element modeling approach. Firstly, a geometric model was created by scanning a polyethylene replica of fetal skull model with a white light three-dimensional scanner. Secondly, a nonlinear finite element model was proposed based on the geometric model. Next, the simulation results of the proposed model were verified against the experimental data reported in other literatures and they showed good agreement with the experimental observations. After this validation, the proposed model was used to simulate the fetal skull deformations under different labor forces. Simulation results illustrated that the fetal skull diameters and modified molding index (MMI) increased when the labor force was increased. Parietal bone around bregma and frontal bone around coronal suture undertook more stress, and parietal and frontal bones around coronal suture undertook more spatial and rotational displacement under larger labor force. The suboccipito-bregmatic diameter (SOBD) was more sensitive to the changes of labor force than other fetal skull diameters. The simulation results revealed the quantitative relationship between the labor force and fetal skull molding during delivery. In the future, if the degree of fetal skull molding is directly related to that of the head injury, the relationship investigated in this study may be used to predict the head injury by measuring the labor force during delivery. (C) 2011 IPEM. Published by Elsevier Ltd. All rights reserved.