title: Modeling the biomechanics of fetal movements.
abstract: Fetal movements in the uterus are a natural part of development and are known to play an important role in normal musculoskeletal development. However, very little is known about the biomechanical stimuli that arise during movements in utero, despite these stimuli being crucial to normal bone and joint formation. Therefore, the objective of this study was to create a series of computational steps by which the forces generated during a kick in utero could be predicted from clinically observed fetal movements using novel cine-MRI data of three fetuses, aged 20-22 weeks. A custom tracking software was designed to characterize the movements of joints in utero, and average uterus deflection of [Formula: see text] mm due to kicking was calculated. These observed displacements provided boundary conditions for a finite element model of the uterine environment, predicting an average reaction force of [Formula: see text] N generated by a kick against the uterine wall. Finally, these data were applied as inputs for a musculoskeletal model of a fetal kick, resulting in predicted maximum forces in the muscles surrounding the hip joint of approximately 8 N, while higher maximum forces of approximately 21 N were predicted for the muscles surrounding the knee joint. This study provides a novel insight into the closed mechanical environment of the uterus, with an innovative method allowing elucidation of the biomechanical interaction of the developing fetus with its surroundings.
authors.affiliation: Department of Bioengineering, Imperial College London, London, SW7 2AZ, UK.
authors.forename: Stefaan W
authors.identifier: 0000-0002-2321-1367
authors.initials: SW
authors.lastname: Verbruggen
authors.affiliation: Department of Bioengineering, Imperial College London, London, SW7 2AZ, UK.
authors.forename: Jessica H W
authors.initials: JH
authors.lastname: Loo
authors.affiliation: Division of Imaging Sciences, Department of Biomedical Engineering, Kings College London, London, UK.
authors.forename: Tayyib T A
authors.initials: TT
authors.lastname: Hayat
authors.affiliation: Division of Imaging Sciences, Department of Biomedical Engineering & Centre for the Developing Brain, Kings College London, London, UK.
authors.forename: Joseph V
authors.initials: JV
authors.lastname: Hajnal
authors.affiliation: Division of Imaging Sciences, Department of Perinatal Imaging and Health & Centre for the Developing Brain, Kings College London, London, UK.
authors.forename: Mary A
authors.initials: MA
authors.lastname: Rutherford
authors.affiliation: Structural Biomechanics, Department of Civil and Environmental Engineering, Imperial College London, London, UK.
authors.forename: Andrew T M
authors.initials: AT
authors.lastname: Phillips
authors.affiliation: Department of Bioengineering, Imperial College London, London, SW7 2AZ, UK. n.nowlan@imperial.ac.uk.
authors.forename: Niamh C
authors.initials: NC
authors.lastname: Nowlan
mesh_terms: D001696:Biomechanical Phenomena; D005324:Fetal Movement / Q000502:physiology*; D020342:Finite Element Analysis; D006621:Hip Joint / Q000502:physiology; D006801:Humans; D007719:Knee Joint / Q000502:physiology; D019028:Magnetic Resonance Imaging, Cine; D008954:Models, Biological
keywords: Cine MRI; Computational model; Developmental dysplasia of the hip; Joint biomechanics; Musculoskeletal development