Human birth observed in real-time open magnetic resonance imaging

Bamberg, Christian; Rademacher, G.; Güttler, Felix; Teichgräber, Ulf; Cremer, Malte; Bührer, Christoph; Spies, Claudia; Hinkson, Larry; Henrich, Wolfgang; Kalache, Karim; Dudenhausen, Joachim W.

doi:10.1016/j.ajog.2012.01.011

Cited by 44 publications

(25 citation statements)

References 44 publications

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“…In obstetric texts, this process is described as the 'seven cardinal movements of labour' (i.e. engagement, descent, flexion, internal rotation, extension, external rotation and expulsion) [10,11]. Rotation is a passive movement that results when the presenting part of the neonate comes in contact with the bony portions of the pelvis and the highly resistant muscles of the pelvic floor.…”

Section: Human Birth: Anatomy Evolutionary History and Modern Conseqmentioning

confidence: 99%

Primate pelvic anatomy and implications for birth

Trevathan

2015

Phil. Trans. R. Soc. B

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The pelvis performs two major functions for terrestrial mammals. It provides somewhat rigid support for muscles engaged in locomotion and, for females, it serves as the birth canal. The result for many species, and especially for encephalized primates, is an 'obstetric dilemma' whereby the neonate often has to negotiate a tight squeeze in order to be born. On top of what was probably a baseline of challenging birth, locomotor changes in the evolution of bipedalism in the human lineage resulted in an even more complex birth process. Negotiation of the bipedal pelvis requires a series of rotations, the end of which has the infant emerging from the birth canal facing the opposite direction from the mother. This pattern, strikingly different from what is typically seen in monkeys and apes, places a premium on having assistance at delivery. Recently reported observations of births in monkeys and apes are used to compare the process in human and nonhuman primates, highlighting similarities and differences. These include presentation (face, occiput anterior or posterior), internal and external rotation, use of the hands by mothers and infants, reliance on assistance, and the developmental state of the neonate.

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Section: Human Birth: Anatomy Evolutionary History and Modern Conseqmentioning

confidence: 99%

Primate pelvic anatomy and implications for birth

Trevathan

2015

Phil. Trans. R. Soc. B

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“…Imaging techniques such as MRI could prove promising in improving our understanding of the mechanism of labor and its implications for the physiological changes taking place during birth [118]. Gas exchange measurements during transition, using capnography, could assist in defining adequate tidal volumes [96,97,98] and the total amount of proper gas exchange.…”

Section: Conclusion and Future Perspectivesmentioning

confidence: 99%

Measuring Physiological Changes during the Transition to Life after Birth

Vonderen¹,

Roest

Siew

et al. 2014

Neonatology

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The transition to life after birth is characterized by major physiological changes in respiratory and hemodynamic function, which are predominantly initiated by breathing at birth and clamping of the umbilical cord. Lung aeration leads to the establishment of functional residual capacity, allowing pulmonary gas exchange to commence. This triggers a significant decrease in pulmonary vascular resistance, consequently increasing pulmonary blood flow and cardiac venous return. Clamping the umbilical cord also contributes to these hemodynamic changes by altering the cardiac preload and increasing peripheral systemic vascular resistance. The resulting changes in systemic and pulmonary circulation influence blood flow through both the oval foramen and ductus arteriosus. This eventually leads to closure of these structures and the separation of the pulmonary and systemic circulations. Most of our knowledge on human neonatal transition is based on human (fetal) data from the 1970s and extrapolation from animal studies. However, there is renewed interest in performing measurements directly at birth. By using less cumbersome techniques (and probably more accurate), our previous understanding of the physiological transition at birth is challenged, as well as the causes and consequences for when this transition fails to progress. This review will provide an overview of physiological measurements of the respiratory and hemodynamic transition at birth. Also, it will give a perspective on some of the upcoming technological advances in physiological measurements of neonatal transition in infants who are unable to make the transition without support.

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“…"Real-time MRI" using an open field machine can be used to demonstrate the progression of the fetal head descent and angulation during active labor [39,40]. With a dedicated sequence, real-time MRI can be particularly useful for fetal cardiac assessment, which may lead to more effective antenatal intervention [41].…”

Section: Miscellaneousmentioning

confidence: 99%

Fetal magnetic resonance imaging and ultrasound

Wataganara

Ebrashy

Aliyu

et al. 2016

Journal of Perinatal Medicine

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Magnetic resonance imaging (MRI) has been increasingly adopted in obstetrics practice in the past three decades. MRI aids prenatal ultrasound and improves diagnostic accuracy for selected maternal and fetal conditions. However, it should be considered only when highquality ultrasound cannot provide certain information that affects the counseling, prenatal intervention, pregnancy course, and delivery plan. Major indications of fetal MRI include, but are not restricted to, morbidly adherent placenta, selected cases of fetal brain anomalies, thoracic lesions (especially in severe congenital diaphragmatic hernia), and soft tissue tumors at head and neck regions of the fetus. For fetal anatomy assessment, a 1.5-Tesla machine with a fast T2-weighted single-shot technique is recommended for image requisition of common fetal abnormalities. Individual judgment needs to be applied when considering usage of a 3-Tesla machine. Gadolinium MRI contrast is not recommended during pregnancy. MRI should be avoided in the first half of pregnancy due to small fetal structures and motion artifacts. Assessment of fetal cerebral cortex can be achieved with MRI in the third trimester. MRI is a viable research tool for noninvasive interrogation of the fetus and the placenta.

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Human birth observed in real-time open magnetic resonance imaging

Cited by 44 publications

References 44 publications

Primate pelvic anatomy and implications for birth

Primate pelvic anatomy and implications for birth

Measuring Physiological Changes during the Transition to Life after Birth

Fetal magnetic resonance imaging and ultrasound

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