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Bai J, Lu Y, Liu H, He F, Guo X. Editorial: New technologies improve maternal and newborn safety. FRONTIERS IN MEDICAL TECHNOLOGY 2024; 6:1372358. [PMID: 38872737 PMCID: PMC11169838 DOI: 10.3389/fmedt.2024.1372358] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Key Words] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/17/2024] [Accepted: 05/17/2024] [Indexed: 06/15/2024] Open
Affiliation(s)
- Jieyun Bai
- Guangdong Provincial Key Laboratory of Traditional Chinese Medicine Information Technology, Jinan University, Guangzhou, China
- Auckland Bioengineering Institute, University of Auckland, Auckland, New Zealand
| | - Yaosheng Lu
- Guangdong Provincial Key Laboratory of Traditional Chinese Medicine Information Technology, Jinan University, Guangzhou, China
| | - Huishu Liu
- Guangzhou Women and Children’s Medical Center, Guangzhou Medical University, Guangzhou, China
| | - Fang He
- Department of Obstetrics and Gynecology, Third Affiliated Hospital of Guangzhou Medical University, Guangzhou, China
| | - Xiaohui Guo
- Department of Obstetrics, Shenzhen People’s Hospital, Shenzhen, China
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Hynčík L, Čechová H, Jansová M, Lv W, Hympánová LH, Krofta L. In silico prediction of maximum perineal muscle strain during vaginal delivery by design of experiment. COMPUTER METHODS AND PROGRAMS IN BIOMEDICINE 2023; 242:107835. [PMID: 37804737 DOI: 10.1016/j.cmpb.2023.107835] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 08/04/2023] [Revised: 09/20/2023] [Accepted: 09/27/2023] [Indexed: 10/09/2023]
Abstract
BACKGROUND AND OBJECTIVE The prevalence of pelvic floor muscle injuries induced by childbirth is higher than 23 % in the general women population. Such injuries can lead to prolapses and other pathologies in future female life. Leveraging computational biomechanics, the study implements an advanced female pelvic floor model for computing the maximum pelvic muscle strain, which serves as an injury risk indicator. The design of experiment method, abbreviated as DoE, is used to compute the maximum strain for boundary values of bony pelvis dimensions, namely the anterior-posterior diameter (abbreviated as APD) and the transverse diameter (abbreviated as TD). This is done in combination with small, medium and large percentiles of fetal head circumference (abbreviated as HC). METHODS We utilized a previously developed finite element model of a female pelvic floor, as a reference, and enhanced it with new features, including a more detailed tissue geometry and advanced constitutive material models. The APD and TD dimensions were sourced from the set of MRI of 64 nulliparous women. This data was used to estimate the boundary dimensions of the female bony pelvis, combining both small and large values of APD and TD. Together with the 10th and the 95th percentiles for HC, a three-dimensional domain was constructed to assess the maximum pelvic muscle strain. In boundary cases, the maximum pelvic muscle strain was computed across 8 full-factorial design models (each situated at one corner of the domain, thereby combining the minimum and the maximum values of APD, TD and HC). This was done to define a response surface that predicts the maximum pelvic muscle strain within the domain. The accuracy of this response surface prediction was validated using 15 additional intermediate design models. These models were placed at the center of the domain (1 point), the centres of the domain boundary surfaces (6 points), and midway along each domain boundary edge (8 points). RESULTS The maximum strain results for 8 combinations of APD, TD, and HC were employed to construct a linear response surface as a function of APD, TD, and HC. Tests at an additional 19 domain points served to evaluate the efficiency of the response surface prediction. The response surface demonstrated strong predictability, with an absolute average error of 1.52 %, an absolute median error of 1.52 %, and an absolute maximum error of 11.11 %. HC emerged as the most influencing dimension, accounting for 16 % of influence. CONCLUSIONS The reference finite element pelvic floor model was scaled to 8 full-factorial female-specific pelvic floor models, which represent the combination of boundary values for APD, TD, and HC. The maximum pelvic floor muscle strain from these 8 models was used to design a response surface. When implementing the DoE approach to construct the response, there was consistent predictability for the maximum perineal muscle strain, as validated by the additional 19 intermediate design models. As a result, the response surface methodology can serve as an initial predictor for potential childbirth-induced pelvic floor muscle injury.
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Affiliation(s)
- Luděk Hynčík
- University of West Bohemia, Pilsen 301 00, Czech Republic.
| | - Hana Čechová
- University of West Bohemia, Pilsen 301 00, Czech Republic
| | | | - Wenle Lv
- Tianjin University of Science and Technology, Tianjin, China
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Singh G, Chanda A. Mechanical properties of whole-body soft human tissues: a review. Biomed Mater 2021; 16. [PMID: 34587593 DOI: 10.1088/1748-605x/ac2b7a] [Citation(s) in RCA: 78] [Impact Index Per Article: 26.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/08/2021] [Accepted: 09/29/2021] [Indexed: 11/11/2022]
Abstract
The mechanical properties of soft tissues play a key role in studying human injuries and their mitigation strategies. While such properties are indispensable for computational modelling of biological systems, they serve as important references in loading and failure experiments, and also for the development of tissue simulants. To date, experimental studies have measured the mechanical properties of peripheral tissues (e.g. skin)in-vivoand limited internal tissuesex-vivoin cadavers (e.g. brain and the heart). The lack of knowledge on a majority of human tissues inhibit their study for applications ranging from surgical planning, ballistic testing, implantable medical device development, and the assessment of traumatic injuries. The purpose of this work is to overcome such challenges through an extensive review of the literature reporting the mechanical properties of whole-body soft tissues from head to toe. Specifically, the available linear mechanical properties of all human tissues were compiled. Non-linear biomechanical models were also introduced, and the soft human tissues characterized using such models were summarized. The literature gaps identified from this work will help future biomechanical studies on soft human tissue characterization and the development of accurate medical models for the study and mitigation of injuries.
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Affiliation(s)
- Gurpreet Singh
- Centre for Biomedical Engineering, Indian Institute of Technology (IIT), Delhi, India
| | - Arnab Chanda
- Centre for Biomedical Engineering, Indian Institute of Technology (IIT), Delhi, India.,Department of Biomedical Engineering, All India Institute of Medical Sciences (AIIMS), Delhi, India
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Goordyal D, Anderson J, Alazmani A, Culmer P. An engineering perspective of vacuum assisted delivery devices in obstetrics: A review. Proc Inst Mech Eng H 2021; 235:3-16. [PMID: 32928047 PMCID: PMC7780266 DOI: 10.1177/0954411920956467] [Citation(s) in RCA: 8] [Impact Index Per Article: 2.7] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/21/2020] [Accepted: 08/13/2020] [Indexed: 11/17/2022]
Abstract
Complications during childbirth result in the need for clinicians to use 'assisted delivery' in over 12% of cases (UK). After more than 50 years in clinical practice, vacuum assisted delivery (VAD) devices remain a mainstay in physically assisting child delivery; sometimes preferred over forceps due to their ease of use and reduced maternal morbidity. Despite their popularity and enduring track-record, VAD devices have shown little evidence of innovation or design change since their inception. In addition, evidence on the safety and functionality of VAD devices remains limited but does present opportunities for improvements to reduce adverse clinical outcomes. Consequently in this review we examine the literature and patent landscape surrounding VAD biomechanics, design evolution and performance from an engineering perspective, aiming to collate the limited but valuable information from a disparate field and provide a series of recommendations to inform future research into improved, safer, VAD systems.
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Affiliation(s)
- Dushyant Goordyal
- University of Leeds Faculty of
Engineering, Mechanical Engineering, Leeds, West Yorkshire, UK
| | - John Anderson
- Bradford Teaching Hospitals NHS
Foundation Trust, Bradford, West Yorkshire, UK
| | - Ali Alazmani
- University of Leeds Faculty of
Engineering, Mechanical Engineering, Leeds, West Yorkshire, UK
| | - Peter Culmer
- University of Leeds Faculty of
Engineering, Mechanical Engineering, Leeds, West Yorkshire, UK
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Grimm MJ. Engineering and women's health: a slow start, but gaining momentum. Interface Focus 2019; 9:20190017. [PMID: 31263535 DOI: 10.1098/rsfs.2019.0017] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 04/29/2019] [Indexed: 12/12/2022] Open
Abstract
While biomedical engineers have participated in research studies that focus on understanding aspects particular to women's health since the 1950s, the depth and breadth of the research have increased significantly in the last 15-20 years. It has been increasingly clear that engineers can lend important knowledge and analysis to address questions that are key to understanding physiology and pathophysiology related to women's health. This historical survey identifies some of the earliest contributions of engineers to exploring aspects of women's health, from the behaviour of key tissues, to issues of reproduction and breast cancer. In addition, some of the more recent work in each area is identified and areas deserving additional attention are described. The interdisciplinary nature of this area of engineering, along with the growing interest within the field of biomedical engineering, promise to bring exciting new discoveries and expand knowledge that will positively impact women's health in the near future.
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Affiliation(s)
- Michele J Grimm
- Wielenga Creative Engineering Endowed Professor, Department of Mechanical Engineering, Michigan State University, East Lansing, MI, USA
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Routzong MR, Moalli PA, Maiti S, De Vita R, Abramowitch SD. Novel simulations to determine the impact of superficial perineal structures on vaginal delivery. Interface Focus 2019; 9:20190011. [PMID: 31263532 DOI: 10.1098/rsfs.2019.0011] [Citation(s) in RCA: 9] [Impact Index Per Article: 1.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 05/07/2019] [Indexed: 11/12/2022] Open
Abstract
This study's aim was to determine whether the inclusion of superficial perineal structures in a finite-element simulation of vaginal delivery impacts the pubovisceral muscle and perineal body, two common sites of birth-related injury. The hypothesis, inferred from prevailing literature, was that these structures would have minimal influence (differences less than ±10%). Two models were made using the Visible Human Project's female cadaver to create a rigid, fixed pelvis, musculature held by spring attachments to that pelvis, and a rigid, ellipsoidal fetal head prescribed with an inferior displacement to simulate delivery. Injury site stretch ratios and fetal head and perineal body displacements and angles of progression were compared between the Omitted Model (which excluded the superficial perineal structures as is common practice) and the Included Model (which included them). Included Model stretch ratios were +107%, -9.84% and -14.6% compared to Omitted Model perineal body and right and left pubovisceral muscles, respectively. Included Model peak perineal body inferior displacement was +72.5% greater while similar anterior-posterior displacements took longer to reach. These results refute our hypothesis, suggesting superficial perineal structures impact simulations of vaginal delivery by inhibiting perineal body anterior-posterior displacement, which stretches and inferiorly displaces the perineal body.
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Affiliation(s)
- Megan R Routzong
- Translational Biomechanics Laboratory, Department of Bioengineering, Swanson School of Engineering, University of Pittsburgh, Pittsburgh, PA, USA
| | - Pamela A Moalli
- Magee-Womens Research Institute, Magee-Womens Hospital, University of Pittsburgh, Pittsburgh, PA, USA
| | - Spandan Maiti
- Department of Bioengineering, Swanson School of Engineering, University of Pittsburgh, Pittsburgh, PA, USA
| | - Raffaella De Vita
- STRETCH Lab, Department of Biomedical Engineering and Mechanics, Virginia Tech, Blacksburg, VA, USA
| | - Steven D Abramowitch
- Translational Biomechanics Laboratory, Department of Bioengineering, Swanson School of Engineering, University of Pittsburgh, Pittsburgh, PA, USA
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Jansova M, Kalis V, Rusavy Z, Räisänen S, Lobovsky L, Laine K. Fetal head size and effect of manual perineal protection. PLoS One 2017; 12:e0189842. [PMID: 29287104 PMCID: PMC5747446 DOI: 10.1371/journal.pone.0189842] [Citation(s) in RCA: 16] [Impact Index Per Article: 2.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/02/2016] [Accepted: 12/03/2017] [Indexed: 11/18/2022] Open
Abstract
OBJECTIVE The aim of this study was to evaluate whether a previously identified modification of Viennese method of perineal protection remains most effective for reduction of perineal tension in cases with substantially smaller or larger fetal heads. METHODS A previously designed finite element model was used to compare perineal tension of different modifications of the Viennese method of perineal protection to "hands-off" technique for three different sizes of the fetal head. Quantity and extent of tension throughout the perineal body during vaginal delivery at the time when the suboccipito-bregmatic circumference passes between the fourchette and the lower margin of the pubis was determined. RESULTS The order of effectiveness of different modifications of manual perineal protection was similar for all three sizes of fetal head. The reduction of perineal tension was most significant in delivery simulations with larger heads. The final position of fingers 2cm anteriorly from the fourchette (y = +2) consistently remains most effective in reducing the tension. The extent of finger movement along the anterior-posterior (y-axis) contributes to the effectiveness of manual perineal protection. CONCLUSION Appropriately performed Viennese manual perineal protection seems to reduce the perineal tension regardless of the fetal head size, and thus the method seems to be applicable to reduce risk of perineal trauma for all parturients.
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Affiliation(s)
- Magdalena Jansova
- New Technologies-Research Centre, University of West Bohemia, Pilsen, Czech Republic
| | - Vladimir Kalis
- Biomedical Centre, Faculty of Medicine in Pilsen, Charles University, Pilsen, Czech Republic.,Department of Obstetrics and Gynecology, University Hospital, Pilsen, Czech Republic
| | - Zdenek Rusavy
- Biomedical Centre, Faculty of Medicine in Pilsen, Charles University, Pilsen, Czech Republic.,Department of Obstetrics and Gynecology, University Hospital, Pilsen, Czech Republic
| | - Sari Räisänen
- University of Helsinki, Helsinki, Finland.,National Library of Finland, Helsinki, Finland
| | - Libor Lobovsky
- NTIS-New Technologies for Information Society, Faculty of Applied Sciences, University of West Bohemia, Pilsen, Czech Republic
| | - Katariina Laine
- Department of Obstetrics, Oslo University Hospital, Oslo, Norway
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Frémondière P, Thollon L, Marchal F. [The emergence of obstetrical mechanism: From Lucy to Homo sapiens]. GYNECOLOGIE, OBSTETRIQUE, FERTILITE & SENOLOGIE 2017; 45:164-171. [PMID: 28256409 DOI: 10.1016/j.gofs.2017.01.011] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 09/29/2016] [Accepted: 01/23/2017] [Indexed: 06/06/2023]
Abstract
The evolutionary history of modern birth mechanism is now a renewed interest in obstetrical papers. The purpose of this work is to review the literature in paleo-obstetrical field. Our analysis focuses on paleo-obstetrical hypothesis, from 1960 to the present day, based on the reconstruction of fossil pelvis. Indeed, these pelvic reconstructions usually provide an opportunity to make an obstetrical assumption in our ancestors. In this analysis, we show that modern birth mechanism takes place during the emergence of our genus 2 million years ago. References are made to human specificities related to obstetrical mechanism: exclusive bipedalism, increase of brain size at birth, metabolic cost of the pregnancy and deep trophoblastic implantation.
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Affiliation(s)
- P Frémondière
- CNRS, EFS, ADES UMR 7268, Aix-Marseille université, faculté de médecine, secteur Nord, boulevard Pierre-Dramard, 13916 Marseille, France; Département de Maïeutique de Montpellier, institut de biologie, université de Montpellier, 4, boulevard Henri-IV, 34000 Montpellier, France.
| | - L Thollon
- IFSTTAR, LBA UMRT 24, Aix-Marseille université, faculté de médecine, secteur Nord, boulevard Pierre-Dramard, 13916 Marseille, France
| | - F Marchal
- Département de Maïeutique de Montpellier, institut de biologie, université de Montpellier, 4, boulevard Henri-IV, 34000 Montpellier, France
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Increasing Age Is a Risk Factor for Decreased Postpartum Pelvic Floor Strength. Female Pelvic Med Reconstr Surg 2017; 23:136-140. [PMID: 28067746 DOI: 10.1097/spv.0000000000000376] [Citation(s) in RCA: 7] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/26/2022]
Abstract
OBJECTIVES This study aimed to determine factors associated with decreased pelvic floor strength (PFS) after the first vaginal delivery (VD) in a cohort of low-risk women. METHODS This is a secondary analysis of a prospective study examining the risk of pelvic floor injury in a cohort of primiparous women. All recruited participants underwent an examination, three-dimensional ultrasound and measurement of PFS in the third trimester and repeated at 4 weeks to 6 months postpartum using a perineometer. RESULTS There were 84 women recruited for the study, and 70 completed the postpartum assessment. Average age was 28.4 years (standard deviation, 4.8). There were 46 (66%) subjects with a VD and 24 (34%) with a cesarean delivery who labored. Decreased PFS was observed more frequently in the VD group compared with the cesarean delivery group (68% vs 42%, P = 0.03).In modified Poisson regression models controlling for mode of delivery and time of postpartum assessment, women who were aged 25 to 29 years (risk ratio = 2.80, 95% confidence interval, 1.03-7.57) and 30 years and older (risk ratio = 2.53, 95% confidence interval, 0.93-6.86) were over 2.5 times more likely to have decreased postpartum PFS compared with women younger than 25 years. CONCLUSIONS In this population, women aged 25 years and older were more than twice as likely to have a decrease in postpartum PFS.
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Clark AR, Kruger JA. Mathematical modeling of the female reproductive system: from oocyte to delivery. WILEY INTERDISCIPLINARY REVIEWS-SYSTEMS BIOLOGY AND MEDICINE 2016; 9. [PMID: 27612162 DOI: 10.1002/wsbm.1353] [Citation(s) in RCA: 6] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Track Full Text] [Subscribe] [Scholar Register] [Received: 03/06/2016] [Revised: 06/08/2016] [Accepted: 06/28/2016] [Indexed: 12/30/2022]
Abstract
From ovulation to delivery, and through the menstrual cycle, the female reproductive system undergoes many dynamic changes to provide an optimal environment for the embryo to implant, and to develop successfully. It is difficult ethically and practically to observe the system over the timescales involved in growth and development (often hours to days). Even in carefully monitored conditions clinicians and biologists can only see snapshots of the development process. Mathematical models are emerging as a key means to supplement our knowledge of the reproductive process, and to tease apart complexity in the reproductive system. These models have been used successfully to test existing hypotheses regarding the mechanisms of female infertility and pathological fetal development, and also to provide new experimentally testable hypotheses regarding the process of development. This new knowledge has allowed for improvements in assisted reproductive technologies and is moving toward translation to clinical practice via multiscale assessments of the dynamics of ovulation, development in pregnancy, and the timing and mechanics of delivery. WIREs Syst Biol Med 2017, 9:e1353. doi: 10.1002/wsbm.1353 For further resources related to this article, please visit the WIREs website.
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Affiliation(s)
- Alys R Clark
- Auckland Bioengineering Institute, University of Auckland, Auckland, New Zealand
| | - Jennifer A Kruger
- Auckland Bioengineering Institute, University of Auckland, Auckland, New Zealand
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Yan X, Kruger JA, Li X, Nielsen PMF, Nash MP. Modeling the second stage of labor. WILEY INTERDISCIPLINARY REVIEWS-SYSTEMS BIOLOGY AND MEDICINE 2016; 8:506-516. [DOI: 10.1002/wsbm.1351] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Track Full Text] [Subscribe] [Scholar Register] [Received: 02/24/2016] [Revised: 06/09/2016] [Accepted: 06/14/2016] [Indexed: 11/09/2022]
Affiliation(s)
- Xiani Yan
- Auckland Bioengineering Institute; University of Auckland; Auckland New Zealand
| | - Jennifer A. Kruger
- Auckland Bioengineering Institute; University of Auckland; Auckland New Zealand
| | - Xinshan Li
- Department of Mechanical Engineering; University of Sheffield; Sheffield UK
| | - Poul M. F. Nielsen
- Auckland Bioengineering Institute; University of Auckland; Auckland New Zealand
- Department of Engineering Science; University of Auckland; Auckland New Zealand
| | - Martyn P. Nash
- Auckland Bioengineering Institute; University of Auckland; Auckland New Zealand
- Department of Engineering Science; University of Auckland; Auckland New Zealand
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Oliveira DA, Parente MP, Calvo B, Mascarenhas T, Natal Jorge RM. Numerical simulation of the damage evolution in the pelvic floor muscles during childbirth. J Biomech 2016; 49:594-601. [DOI: 10.1016/j.jbiomech.2016.01.014] [Citation(s) in RCA: 26] [Impact Index Per Article: 3.3] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/22/2015] [Revised: 01/13/2016] [Accepted: 01/28/2016] [Indexed: 01/30/2023]
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13
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Rostaminia G, Abramowitch S. Finite Element Modeling in Female Pelvic Floor Medicine: a Literature Review. CURRENT OBSTETRICS AND GYNECOLOGY REPORTS 2015. [DOI: 10.1007/s13669-015-0115-1] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/26/2023]
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14
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Nagle AS, Barker MA, Kleeman SD, Haridas B, Douglas Mast T. Passive biomechanical properties of human cadaveric levator ani muscle at low strains. J Biomech 2014; 47:583-6. [DOI: 10.1016/j.jbiomech.2013.11.033] [Citation(s) in RCA: 17] [Impact Index Per Article: 1.7] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/26/2013] [Revised: 09/23/2013] [Accepted: 11/21/2013] [Indexed: 11/17/2022]
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Frangi AF, Hose DR, Hunter PJ, Ayache N, Brooks D. Special issue on medical imaging and image computing in computational physiology. IEEE TRANSACTIONS ON MEDICAL IMAGING 2013; 32:1-7. [PMID: 23409282 DOI: 10.1109/tmi.2012.2234320] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 06/01/2023]
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Güttler FV, Heinrich A, Rump J, de Bucourt M, Schnackenburg B, Bamberg C, Hamm B, Teichgräber UK. Magnetic resonance imaging of the active second stage of labour: proof of principle. Eur Radiol 2012; 22:2020-6. [PMID: 22549105 DOI: 10.1007/s00330-012-2455-9] [Citation(s) in RCA: 6] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/17/2011] [Revised: 02/09/2012] [Accepted: 02/23/2012] [Indexed: 11/25/2022]
Abstract
OBJECTIVE To prove that magnetic resonance imaging of foetal anatomy during the active second stage of vaginal delivery is feasible. MATERIALS AND METHODS Initially, five pregnant volunteers around the 30th week of gestation were examined in an open MRI. Based on the findings, one vaginal delivery was acquired under real-time imaging. To monitor the birth status during image acquisition, an MR-compatible wireless cardiotocography (CTG) system was built. Single-shot sequence parameters were optimised to compensate motion artefacts during labour. RESULTS Safety requirements to monitor the birth process under real-time MR imaging were met. High-resolution MR images were acquired immediately before and after delivery. In one patient, TSE single-shot cinematic sequences of the active second stage of labour were obtained. All sequences were adapted to tolerate movement of the mother and infant, as well as residual noise from the CTG. Furthermore, the MR imaging during labour showed only minor image artefacts. CONCLUSION CTG-monitored acquisition of MRI series during the active second stage of delivery is feasible. Image quality should allow various further studies to improve models for birth simulation as well as potential investigation of obstructed labour and obstetric complications.
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Affiliation(s)
- F V Güttler
- Department of Radiology, Charité University Hospital, Charitéplatz 1, 10117 Berlin, Germany.
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