On the Mechanical Aspects of Shoulder Dystocia and Birth Injury

Allen, Robert H.

doi:10.1097/grf.0b013e31811eb8e2

Cited by 31 publications

(20 citation statements)

References 49 publications

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“…Unusual birth injuries have been reported [11][12][13][14][15][16][17][18][19][20][21][22][23]. There are at least 2 previous reports of severe intrauterine tear in a baby as a result of birth trauma.…”

Section: Discussionmentioning

confidence: 97%

“…Minor injuries to the genitalia such as abrasions, cellulites, and hematoma are not uncommon and usually heal in a few days [6][7][8][9][10]. Severe birth trauma is infrequent, although case reports of injuries to the skull, spinal cord, brachial plexus, Erb palsy, Klumke's palsy, paralyzed diaphragm, and injured abdominal viscera are documented in the literature [11][12][13][14][15][16][17][18][19][20][21][22][23]. Caesarian delivery, which is frequently performed for obstructed labor has greatly reduced the incidence of birth injuries [13].…”

Section: Discussionmentioning

confidence: 99%

See 1 more Smart Citation

Intrauterine rectovaginal tear during a manual attempt to rotate a neonate

Al-Benna¹,

Tzakas²

2010

Journal of Pediatric Surgery

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Section: Discussionmentioning

confidence: 97%

Section: Discussionmentioning

confidence: 99%

Intrauterine rectovaginal tear during a manual attempt to rotate a neonate

Al-Benna¹,

Tzakas²

2010

Journal of Pediatric Surgery

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“…Some of these tools permit the simulation of instrumented deliveries using forceps [2]. For example, the Hopkins-designed birth simulator is oriented towards shoulder dystocia [3], [4] and the Noelle TM simulator marketed by Gaumard offers a complete robotized anthropomorphic system including fetal cardiac rhythm [5].…”

Section: Introductionmentioning

confidence: 99%

Biomechanical simulation of the fetal descent without imposed theoretical trajectory

Buttin

Zara

Shariat

et al. 2013

Computer Methods and Programs in Biomedicine

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Abstract-The medical training concerning childbirth for young obstetricians involves performing real deliveries, under supervision. This medical procedure becomes more complicated when instrumented deliveries requiring the use of forceps or suction cups become necessary. For this reason, the use of a versatile, configurable childbirth simulator, taking into account different anatomical and pathological cases, would provide an important benefit in the training of obstetricians, and improve medical procedures. The production of this type of simulator should be generally based on a computerized birth simulation, enabling the computation of the reproductive organs of the parturient woman and fetal interactions as well as the calculation of efforts produced during the second stage of labor. However, apart from the commercially available robotized dummy simulators, very few virtual training tools using computational technologies have been developed. Unfortunately, all of these simulators approximate the expulsive forces of childbirth by imposing a pre-computed fetal trajectory. They have rather limited possibilities and would be unlikely to meet the versatility requirements described above. Besides, much research work has been carried out to simulate precisely birth-induced pelvic floor dysfunction and organ prolapse, with damage to levator ani muscles. All these simulators perform a detailed modeling of the levator ani muscles in interaction with a rigid fetal head, at high computational cost. However, they do not take into consideration many pelvic organs involved in the process of childbirth.To reconcile the accuracy of results and computation time, we propose an approach that lies between the two classes of simulator described above in order to perform a realistic simulation of the descent of the fetus through the birth canal. In this paper we present the first stage of this work by focusing on the geometrical and biomechanical modeling of the main organs involved (i. e. the uterus, abdomen and pelvis of the parturient woman interacting with the fetus) based on the laws of continuum mechanics. At this stage, to verify the correctness of our hypothesis, we use finite element analysis, because of its reliability, precision and stability. In sum, our study improves work performed on childbirth simulators because:• our childbirth model takes into account all the major organs involved in birth process, thus enabling many childbirth scenarios to be considered, • fetal head is not treated as a rigid body and its motion is computed by taking into account realistic boundary conditions, i. e. we do not impose a pre-computed fetal trajectory, • we take into account the cyclic uterine contractions as well as voluntary efforts produced by the muscles of the abdomen, • a slight pressure is added inside the abdomen, representing the residual muscle tone.

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“…I n brachial plexus birth palsy, the brachial plexus is injured during the birth process, usually due to shoulder dystocia 4 . While many infants spontaneously recover from brachial plexus nerve palsy, a substantial proportion of infants are left with permanent disability in an upper limb.…”

Section: Postnatal Nerve Damagementioning

confidence: 99%