title: [Prevention of human birth trauma I. Computer-assisted simulation of delivery using magnetic resonance tomography and finite element analysis].
abstract: Imaging procedures suitable for diagnosis of cephalopelvic disproportion, such as radiological pelvimetry, computer- or magnetic resonance imaging (MRI) fail to reflect the dynamics of delivery, including deformations of the birth channel as well as of foetal structures. In order to validate findings of imaging procedures in this respect, a method has been developed to perform dynamic, biomechanical postprocessing of the static information obtained from MRI. Using a specially developed software MRI pixel, matrices of the maternal pelvis and the foetal head were colour-coded and--according to the principle of equal density--line data were created. After sectional attribution of the resulting polygones, a three-dimensional mesh of so called Finite Elements (FE) was created, which can then be used for deformation analysis. The foetal head was then moved through the birth channel by means of computed simulation. This allows not only ongoing deformations to be visualised, but also resulting forces can be calculated at any time of the delivery process for any point of the anatomical model. Furthermore, these calculations can be performed assuming various conditions such as different cephalopelvic dimensions and various labour forces or biomechanical properties of the tissues involved. This paper aims at presenting the method and its mode of working by means of one example of a computed birth simulation.
authors.affiliation: Frauenklinik, Klinikum Mannheim.
authors.forename: A
authors.initials: A
authors.lastname: Wischnik
authors.forename: E
authors.initials: E
authors.lastname: Nalepa
authors.forename: K J
authors.initials: KJ
authors.lastname: Lehmann
authors.forename: K U
authors.initials: KU
authors.lastname: Wentz
authors.forename: M
authors.initials: M
authors.lastname: Georgi
authors.forename: F
authors.initials: F
authors.lastname: Melchert
mesh_terms: D000328:Adult; D001696:Biomechanical Phenomena; D001720:Birth Injuries / Q000517:prevention & control*; D002543:Cerebral Hemorrhage / Q000517:prevention & control; D003198:Computer Simulation; D004420:Dystocia / Q000175:diagnosis*; D005260:Female; D006801:Humans; D007091:Image Processing, Computer-Assisted / Q000295:instrumentation*; D007231:Infant, Newborn; D008279:Magnetic Resonance Imaging / Q000295:instrumentation*; D008953:Models, Anatomic; D010387:Pelvimetry / Q000295:instrumentation*; D011247:Pregnancy; D012984:Software