A Computational Procedure to Derive the Curve of Carus for Childbirth Computational Modeling
A Computational Procedure to Derive the Curve of Carus for Childbirth Computational Modeling
复制标题
推导用于分娩计算模型的 Carus 曲线的计算程序
DOI：
10.1115/1.4055108
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发表时间：
2023
期刊：
影响因子：
--
通讯作者：
Grimm, Michele J.
中科院分区：
文献类型：
--
作者：
Chen, Sheng;Routzong, Megan R.;Abramowitch, Steven D.;Grimm, Michele J.
计算模型在分娩相关研究中发挥着重要作用。指定的胎儿下降轨迹是分娩模拟中的一个关键特征。在文献中可以确定两种主要类型的完全规定的胎儿下降轨迹：直线下降轨迹和Carus曲线。直线下降轨迹的优点是更简单，可以作为分娩期间相对较小的胎儿运动的合理近似值，但它不能用于模拟整个分娩过程。CARUS曲线是公认的具有生理意义的胎儿下降轨迹。然而，在现有的计算研究中，还没有从几何上定义CARU曲线的详细程序。文献中CARUS模拟曲线的这种状态阻碍了跨不同研究的结果的直接比较和建立在先前研究基础上的计算技术的进步。这项研究的目标是：(1)提出一种通用的方法来推导第二产程从胎头与骨盆接合到胎头完全分娩时的CARUS曲线；以及(2)在考虑各种胎头大小的情况下证明其实用性。目前的研究提供了CARUS曲线的详细公式，考虑了母亲和胎儿的几何形状。孕妇的几何形状是从MRI数据中获得的，而胎头的几何形状是基于对真实胎头的复制品进行激光扫描的。
Computational modeling serves an important role in childbirth-related research. Prescribed fetal descent trajectory is a key characteristic in childbirth simulations. Two major types of fully prescribed fetal descent trajectories can be identified in the literature: straight descent trajectories and curve of Carus. The straight descent trajectory has the advantage of being simpler and can serve as a reasonable approximation for relatively small fetal movements during labor, but it cannot be used to simulate the entire childbirth process. The curve of Carus is the well-recognized fetal descent trajectory with physiological significance. However, no detailed procedure to geometrically define the curve of Carus can be found in existing computational studies. This status of curve of Carus simulation in the literature hinders the direct comparison of results across different studies and the advancement of computational techniques built upon previous research. The goals of this study are: (1) propose a universal approach to derive the curve of Carus for the second stage of labor, from the point when the fetal head engages the pelvis to the point when the fetal head is fully delivered; and (2) demonstrate its utility when considering various fetal head sizes. The current study provides a detailed formulation of the curve of Carus, considering geometries of both the mother and the fetus. The maternal geometries were obtained from MRI data, and the fetal head geometries were based on laser scanning of a replica of a real fetal head.