Comparative anatomy on 3-D MRI of the urogenital sinus and the periurethral area before and during the second stage of labor during childbirth

Maran, Jean-Christophe; Cassagnes, L.; Delmas, V.; Musset, D.; Frydman, R; Mage, G.; Canis, Michel; Boyer, L.; Ami, O.

doi:10.1007/s00276-017-1925-9

Cited by 10 publications

(13 citation statements)

References 34 publications

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“…Seven pregnant women were examined with 3D MRI before going into labor and during the second stage of labor [6]. This prospective biomedical observational study (IMAGINAITRE) was approved by the French ethical Institutional Review Board "Ile de France II" (ID-RCB 2012-A01469-34) and by the French National Agency for Drug and Medical Product Safety ( Agence Nationale de Sécurité du Médicament et des Produits de Santé ) and promoted by the University of Clermont-Ferrand Medical Center.…”

Section: Methodsmentioning

confidence: 99%

“…Special considerations were made for the safety of mother and child as previously described[6]. Briefly, patients were cared for during the study by dedicated teams consisting of an obstetrician, radiologist, midwife, and pediatrician.…”

Section: Methodsmentioning

confidence: 99%

“…The physical characteristics of these seven women and their birthing processes have been described [6]. The women were 23–34 years of age, beyond 39 weeks gestation, and had a Magnin score of 25.1 to 27.5.…”

Section: Methodsmentioning

confidence: 99%

“…Little is known about the possible causes or mechanisms of labor dystocia and brain and retinal hemorrhage. Predictive models, such as the three-dimensional (3D) birth simulation software Predibirth (Olivier Ami, France), require study of the process of birth with 3D imaging [6].…”

Section: Introductionmentioning

confidence: 99%

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Three-dimensional magnetic resonance imaging of fetal head molding and brain shape changes during the second stage of labor

Ami¹,

Maran²,

Gábor³

et al. 2019

PLoS ONE

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To demonstrate and describe fetal head molding and brain shape changes during delivery, we used three-dimensional (3D) magnetic resonance imaging (MRI) and 3D finite element mesh reconstructions to compare the fetal head between prelabor and the second stage of labor. A total of 27 pregnant women were examined with 3D MRI sequences before going into labor using a 1 Tesla open field MRI. Seven of these patients subsequently had another set of 3D MRI sequences during the second stage of labor. Volumes of 2D images were transformed into finite element 3D reconstructions. Polygonal meshes for each part of the fetal body were used to study fetal head molding and brain shape changes. Varying degrees of fetal head molding were present in the infants of all seven patients studied during the second phase of labor compared with the images acquired before birth. The cranial deformation, however, was no longer observed after birth in five out of the seven newborns, whose post-natal cranial parameters were identical to those measured before delivery. The changing shape of the fetal brain following the molding process and constraints on the brain tissue were observed in all the fetuses. Of the three fetuses presenting the greatest molding of the skull bones and brain shape deformation, two were delivered by cesarean-section (one after a forceps failure and one for engagement default), while the fetus presenting with the greatest skull molding and brain shape deformation was born physiologically. This study demonstrates the value of 3D MRI study with 3D finite element mesh reconstruction during the second stage of labor to reveal how the fetal brain is impacted by the molding of the cranial bones. Fetal head molding was systematically observed when the fetal head was engaged between the superior pelvic strait and the middle brim.

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Section: Methodsmentioning

confidence: 99%

Section: Methodsmentioning

confidence: 99%

Section: Methodsmentioning

confidence: 99%

Section: Introductionmentioning

confidence: 99%

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Three-dimensional magnetic resonance imaging of fetal head molding and brain shape changes during the second stage of labor

Ami¹,

Maran²,

Gábor³

et al. 2019

PLoS ONE

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“…48 However, instrumental extractions are also associated with greater maternal perineal trauma. 49 Future versions of the PREDIBIRTH software will include recent observations made on the maternal urogenital sinus changes during the second phase of labor with MRI 50 , and it will evaluate the levator ani stretching when the fetal head molding has been intense.…”

Section: Discussionmentioning

confidence: 99%

Childbirth simulation to assess cephalopelvic dystocia and chances for failed labor

Ami¹,

Maran²,

Cohen³

et al. 2021

Preprint

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Objectives: Reducing the rate of failed labor and emergency caesarean section is of vital significance. A childbirth simulation software tool based on 5 minutes’ magnetic resonance imaging (MRI) performed at 37 weeks’ gestation, used to enhance the consulting obstetrician’s ability to predict the optimal delivery mode. Here, we aimed to analyze the predictive ability of this childbirth simulation software tool for choosing the optimal delivery mode compared with not using it. Methods: A retrospective cohort study was performed on 401 patients referred by their obstetrician for MRI pelvimetry at approximately 37 weeks of gestation between December 15, 2015 and December 15, 2016. We employed a childbirth simulation software to predict the optimal delivery mode. Those results were compared with results from the actual delivery mode. Results: The rate of emergency caesarean sections, inappropriately scheduled caesarean sections, and instrumental vaginal deliveries would have been reduced by 30·1%, 20·7%, and 20%, respectively, had the predictions from the childbirth simulation software been considered. The use of the childbirth simulation software did not significantly affect the overall caesarean section rate, but it improved the allocation between scheduled and emergency caesarean sections. Conclusions: The routine use of the childbirth simulation software as a clinical support tool for choosing the optimal delivery mode of singleton pregnancies with a cephalic presentation could reduce the number of emergency caesarean sections, insufficiently justified Caesarean sections, and instrumental deliveries.

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Assessment of Perineal Scars on Translabial Pelvic Floor Ultrasound: A Pilot Study

Housmans

Gillor

Shek

et al. 2022

J of Ultrasound Medicine

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Objective We aimed to describe a method for identifying and evaluating perineal scars using translabial pelvic floor ultrasound. We hypothesized that translabial ultrasound can identify a perineal scar and can differentiate episiotomies from spontaneous tears. Methods This pilot study is a secondary analysis of data obtained in the Epi‐No® trial. Perineal integrity was assessed using volumes acquired on pelvic floor muscle contraction according to the method previously described for anal sphincter imaging. A scar was diagnosed if a hypoechoic distortion in the perineum was noted. We postulated that an episiotomy would result in a linear scar visible on four dimensional translabial ultrasound whereas nonlinear scars were considered the result of spontaneous perineal tear of grade 2 or higher. The results of this assessment were compared with data retrieved from electronic medical records. Results A scar was identified in 79/120 women (66%): 42 (35%) linear and 37 (31%) nonlinear. Sonographic and clinical diagnosis agreed on the presence or absence of perineal trauma in 66%. Agreement for the type of laceration was 50%. Conclusion In this retrospective pilot study, a blinded assessment of translabial ultrasound volume data showed agreement between clinical data and sonographic assessment of perineal integrity in 66% and of type of laceration in 50%. More work is needed to optimize the method in assessment of perineal scars to improve its performance before it can be used in clinical audit and research.

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Comparative anatomy on 3-D MRI of the urogenital sinus and the periurethral area before and during the second stage of labor during childbirth

Cited by 10 publications

References 34 publications

Three-dimensional magnetic resonance imaging of fetal head molding and brain shape changes during the second stage of labor

Three-dimensional magnetic resonance imaging of fetal head molding and brain shape changes during the second stage of labor

Childbirth simulation to assess cephalopelvic dystocia and chances for failed labor

Assessment of Perineal Scars on Translabial Pelvic Floor Ultrasound: A Pilot Study

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