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A numerical study on fetal head molding during labor.

Rita Moura1,2, Margarida Borges1,2, Maria C P Vila Pouca2

  • 1Department of Mechanical Engineering, Faculty of Engineering of the University of Porto, Porto, Portugal.

International Journal for Numerical Methods in Biomedical Engineering
|November 1, 2020
PubMed
Summary

Fetal head molding during childbirth can be excessive, potentially causing disorders. This study used biomechanical modeling to show that prolonged labor increases molding, which may reduce pelvic floor muscle strain and injury risk.

Keywords:
childbirth simulationfinite element methodmechanics of labormolding indexviscoelasticity

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Area of Science:

  • Biomedical Engineering
  • Obstetrics
  • Computational Mechanics

Background:

  • Fetal head molding is a natural adaptation during vaginal delivery.
  • Excessive molding can result from prolonged labor or strong contractions, leading to fetal head disorders.

Purpose of the Study:

  • To numerically investigate the biomechanics of fetal head molding.
  • To analyze the impact of labor duration and pelvic floor muscles on molding and potential fetal injury.

Main Methods:

  • Developed a finite element model of the fetal body and pelvic floor muscles.
  • Modeled the fetal head with skin, skull sutures/fontanelles (visco-hyperelastic membrane elements), and brain.
  • Simulated the second stage of labor (vertex presentation, occipito-anterior position) incorporating viscoelasticity.

Main Results:

  • Prolonged labor simulations showed increased fetal head molding.
  • The birth canal and pelvic floor muscles contributed to 9.1% molding.
  • Pelvic floor muscles experienced a 19.4% reduction in reaction forces and 2.58% less stretching, suggesting reduced injury risk with sufficient molding.

Conclusions:

  • Fetal head molding is influenced by labor duration and biomechanical forces.
  • Adequate molding may mitigate pelvic floor muscle strain and injury.
  • Non-invasive computational methods can help anticipate fetal complications during labor.