Nowlan N C
Department of Bioengineering, Imperial College London, London SW7 2AZ,
Eur Cell Mater. 2015 Jan 2;29:1-21; discussion 21. doi: 10.22203/ecm.v029a01.
Foetal movements commence at seven weeks of gestation, with the foetal movement repertoire including twitches, whole body movements, stretches, isolated limb movements, breathing movements, head and neck movements, jaw movements (including yawning, sucking and swallowing) and hiccups by ten weeks of gestational age. There are two key biomechanical aspects to gross foetal movements; the first being that the foetus moves in a dynamically changing constrained physical environment in which the freedom to move becomes increasingly restricted with increasing foetal size and decreasing amniotic fluid. Therefore, the mechanical environment experienced by the foetus affects its ability to move freely. Secondly, the mechanical forces induced by foetal movements are crucial for normal skeletal development, as evidenced by a number of conditions and syndromes for which reduced or abnormal foetal movements are implicated, such as developmental dysplasia of the hip, arthrogryposis and foetal akinesia deformation sequence. This review examines both the biomechanical effects of the physical environment on foetal movements through discussion of intrauterine factors, such as space, foetal positioning and volume of amniotic fluid, and the biomechanical role of gross foetal movements in human skeletal development through investigation of the effects of abnormal movement on the bones and joints. This review also highlights computational simulations of foetal movements that attempt to determine the mechanical forces acting on the foetus as it moves. Finally, avenues for future research into foetal movement biomechanics are highlighted, which have potential impact for a diverse range of fields including foetal medicine, musculoskeletal disorders and tissue engineering.
胎动在妊娠7周时开始，到孕10周时，胎动模式包括抽搐、全身运动、伸展、孤立的肢体运动、呼吸运动、头部和颈部运动、下颌运动（包括打哈欠、吸吮和吞咽）以及打嗝。胎儿的总体运动有两个关键的生物力学方面；第一个方面是，胎儿在一个动态变化的受限物理环境中运动，随着胎儿体积的增大和羊水的减少，其运动自由度越来越受到限制。因此，胎儿所经历的机械环境会影响其自由运动的能力。其次，胎儿运动所产生的机械力对正常骨骼发育至关重要，这一点已在一些与胎儿运动减少或异常有关的病症和综合征中得到证实，如髋关节发育不良、关节挛缩症和胎儿运动不能变形序列。这篇综述通过讨论子宫内因素，如空间、胎儿位置和羊水量，来研究物理环境对胎儿运动的生物力学影响，以及通过研究异常运动对骨骼和关节的影响，来探讨胎儿总体运动在人类骨骼发育中的生物力学作用。这篇综述还强调了胎儿运动的计算模拟，这些模拟试图确定胎儿运动时作用在其上的机械力。最后，强调了胎儿运动生物力学未来的研究方向，这些方向对包括胎儿医学、肌肉骨骼疾病和组织工程在内的众多领域都有潜在影响。
