Pregnancy state before the onset of labor: a holistic mechanical perspective.
Biomech Model Mechanobiol
; 23(5): 1531-1550, 2024 Oct.
Article
in En
| MEDLINE
| ID: mdl-38758337
ABSTRACT
Successful pregnancy highly depends on the complex interaction between the uterine body, cervix, and fetal membrane. This interaction is synchronized, usually following a specific sequence in normal vaginal deliveries (1) cervical ripening, (2) uterine contractions, and (3) rupture of fetal membrane. The complex interaction between the cervix, fetal membrane, and uterine contractions before the onset of labor is investigated using a complete third-trimester gravid model of the uterus, cervix, fetal membrane, and abdomen. Through a series of numerical simulations, we investigate the mechanical impact of (i) initial cervical shape, (ii) cervical stiffness, (iii) cervical contractions, and (iv) intrauterine pressure. The findings of this work reveal several key observations (i) maximum principal stress values in the cervix decrease in more dilated, shorter, and softer cervices; (ii) reduced cervical stiffness produces increased cervical dilation, larger cervical opening, and decreased cervical length; (iii) the initial cervical shape impacts final cervical dimensions; (iv) cervical contractions increase the maximum principal stress values and change the stress distributions; (v) cervical contractions potentiate cervical shortening and dilation; (vi) larger intrauterine pressure (IUP) causes considerably larger stress values and cervical opening, larger dilation, and smaller cervical length; and (vii) the biaxial strength of the fetal membrane is only surpassed in the cases of the (1) shortest and most dilated initial cervical geometry and (2) larger IUP.
Key words
Full text:
1
Database:
MEDLINE
Main subject:
Cervix Uteri
Limits:
Female
/
Humans
/
Pregnancy
Language:
En
Journal:
Biomech Model Mechanobiol
Journal subject:
ENGENHARIA BIOMEDICA
Year:
2024
Type:
Article
Affiliation country:
Portugal