Three-dimensional magnetic resonance imaging of fetal head molding and brain shape changes during the second stage of labor

Autor: Louis Boyer, Gérard Mage, Jean Christophe Maran, Eric B. Whitacre, Dominique Musset, Petra Gabor, Olivier Ami, Claude Dubray
Rok vydání: 2019
Předmět:
Embryology
Maternal Health
Diagnostic Radiology
030218 nuclear medicine & medical imaging
Labor and Delivery
0302 clinical medicine
Pregnancy
Medicine and Health Sciences
Fetal head
Stage (cooking)
Musculoskeletal System
Multidisciplinary
medicine.diagnostic_test
Radiology and Imaging
Physics
Obstetrics and Gynecology
Classical Mechanics
Brain
Organ Size
Anatomy
Magnetic Resonance Imaging
Deformation
medicine.anatomical_structure
Physical Sciences
Medicine
Female
Research Article
Adult
Imaging Techniques
Science
Forceps
Molding (process)
Research and Analysis Methods
Young Adult
03 medical and health sciences
Fetus
Imaging
Three-Dimensional
Diagnostic Medicine
Labor Stage
Second
medicine
Humans
Skeleton
Fetuses
Damage Mechanics
business.industry
Skull
Biology and Life Sciences
Magnetic resonance imaging
Frontal Bones
Birth
Women's Health
Head (vessel)
business
Head
030217 neurology & neurosurgery
Developmental Biology
Zdroj: PLoS ONE, Vol 14, Iss 5, p e0215721 (2019)
PLoS ONE
ISSN: 1932-6203
DOI: 10.1371/journal.pone.0215721
Popis: To demonstrate and describe fetal head molding and brain shape changes during delivery, we used three-dimensional (3D) magnetic resonance imaging (MRI) and 3D finite element mesh reconstructions to compare the fetal head between prelabor and the second stage of labor. A total of 27 pregnant women were examined with 3D MRI sequences before going into labor using a 1 Tesla open field MRI. Seven of these patients subsequently had another set of 3D MRI sequences during the second stage of labor. Volumes of 2D images were transformed into finite element 3D reconstructions. Polygonal meshes for each part of the fetal body were used to study fetal head molding and brain shape changes. Varying degrees of fetal head molding were present in the infants of all seven patients studied during the second phase of labor compared with the images acquired before birth. The cranial deformation, however, was no longer observed after birth in five out of the seven newborns, whose post-natal cranial parameters were identical to those measured before delivery. The changing shape of the fetal brain following the molding process and constraints on the brain tissue were observed in all the fetuses. Of the three fetuses presenting the greatest molding of the skull bones and brain shape deformation, two were delivered by cesarean-section (one after a forceps failure and one for engagement default), while the fetus presenting with the greatest skull molding and brain shape deformation was born physiologically. This study demonstrates the value of 3D MRI study with 3D finite element mesh reconstruction during the second stage of labor to reveal how the fetal brain is impacted by the molding of the cranial bones. Fetal head molding was systematically observed when the fetal head was engaged between the superior pelvic strait and the middle brim.
Databáze: OpenAIRE
Externí odkaz: