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研究不同尺寸的硅胶橡胶真空吸引器在分娩过程中对胎儿头部的影响：一项有限元分析研究。

Investigating the Effects of Different Sizes of Silicone Rubber Vacuum Extractors during the Course of Delivery on the Fetal Head: A Finite Element Analysis Study.

作者信息

Huang Chuang-Yen, Su Kuo-Min, Pan Hsueh-Hsing, Chang Fung-Wei, Lai Yu-Ju, Chang Hung-Chih, Chen Yu-Chi, Lin Chi-Kang, Su Kuo-Chih

机构信息

Department of Obstetrics and Gynecology, Tri-Service General Hospital, National Defense Medical Center, Taipei 114, Taiwan.

School of Nursing, National Defense Medical Center, Taipei 114, Taiwan.

出版信息

Polymers (Basel). 2022 Feb 14;14(4):723. doi: 10.3390/polym14040723.

DOI:10.3390/polym14040723
PMID:35215636
原文链接:https://pmc.ncbi.nlm.nih.gov/articles/PMC8879916/
Abstract

During certain clinical situations, some parturients require instruments for operative vaginal delivery, and various designs of vacuum extractors may affect the fetal head. To investigate the biomechanical effects of divergent sizes of silicone rubber vacuum extractors, we employed finite element analysis in this study. First, we constructed computer models for different vacuum extractor sizes (diameters: 40 mm, 50 mm, 60 mm, and 70 mm), flat surface, hemispherical ball, and fetal head shape. A hemispherical ball was the main design for the vacuum extractor model, and the material used for the vacuum extractor was silicone rubber. Next, the settings of 1 mm vacuum extractor displacement and vacuum cap pressure of 60 cmHg were applied. The main observation markers of this study were the respective von Mises stresses on the vacuum extractor and skull by the reaction force on the fixed end. The concluded results revealed that vacuum extractors with larger diameters lead to greater reaction force, stress, and strain on fetal heads. Therefore, this study's biomechanical analytic consequences suggest that clinicians avoid selecting larger vacuum extractors during operative instrumental delivery so that fetal heads will experience less external force, deformation, and resultant complications. It could also provide a practical reference for obstetricians for instrumental vaginal delivery with the vacuum extractor made of silicone rubber.

摘要

在某些临床情况下，一些产妇需要器械进行阴道助产，而各种设计的真空吸引器可能会影响胎儿头部。为了研究不同尺寸的硅橡胶真空吸引器的生物力学效应，我们在本研究中采用了有限元分析。首先，我们构建了不同真空吸引器尺寸（直径：40毫米、50毫米、60毫米和70毫米）、平面、半球形球和胎儿头部形状的计算机模型。半球形球是真空吸引器模型的主要设计，真空吸引器使用的材料是硅橡胶。接下来，施加1毫米的真空吸引器位移设置和60厘米汞柱的真空帽压力。本研究的主要观察指标是固定端反作用力作用下真空吸引器和颅骨上各自的冯·米塞斯应力。得出的结果表明，直径较大的真空吸引器会导致胎儿头部产生更大的反作用力、应力和应变。因此，本研究的生物力学分析结果表明，临床医生在器械助产时应避免选择较大尺寸的真空吸引器，以使胎儿头部受到的外力、变形和由此产生的并发症减少。它还可以为产科医生使用硅橡胶制成的真空吸引器进行阴道助产提供实际参考。

https://cdn.ncbi.nlm.nih.gov/pmc/blobs/8448/8879916/1340e4ece265/polymers-14-00723-g010.jpg
https://cdn.ncbi.nlm.nih.gov/pmc/blobs/8448/8879916/c7699c932711/polymers-14-00723-g001.jpg
https://cdn.ncbi.nlm.nih.gov/pmc/blobs/8448/8879916/1722a07bf87c/polymers-14-00723-g002.jpg
https://cdn.ncbi.nlm.nih.gov/pmc/blobs/8448/8879916/0683ea8d994b/polymers-14-00723-g003.jpg
https://cdn.ncbi.nlm.nih.gov/pmc/blobs/8448/8879916/cc3d46173bea/polymers-14-00723-g004.jpg
https://cdn.ncbi.nlm.nih.gov/pmc/blobs/8448/8879916/9904c3f4fe2c/polymers-14-00723-g005.jpg
https://cdn.ncbi.nlm.nih.gov/pmc/blobs/8448/8879916/f42493b0c44f/polymers-14-00723-g006.jpg
https://cdn.ncbi.nlm.nih.gov/pmc/blobs/8448/8879916/36add430e35c/polymers-14-00723-g007.jpg
https://cdn.ncbi.nlm.nih.gov/pmc/blobs/8448/8879916/7dfee1ed68be/polymers-14-00723-g008.jpg
https://cdn.ncbi.nlm.nih.gov/pmc/blobs/8448/8879916/43e5e5ac4c76/polymers-14-00723-g009.jpg
https://cdn.ncbi.nlm.nih.gov/pmc/blobs/8448/8879916/1340e4ece265/polymers-14-00723-g010.jpg
https://cdn.ncbi.nlm.nih.gov/pmc/blobs/8448/8879916/c7699c932711/polymers-14-00723-g001.jpg
https://cdn.ncbi.nlm.nih.gov/pmc/blobs/8448/8879916/1722a07bf87c/polymers-14-00723-g002.jpg
https://cdn.ncbi.nlm.nih.gov/pmc/blobs/8448/8879916/0683ea8d994b/polymers-14-00723-g003.jpg
https://cdn.ncbi.nlm.nih.gov/pmc/blobs/8448/8879916/cc3d46173bea/polymers-14-00723-g004.jpg
https://cdn.ncbi.nlm.nih.gov/pmc/blobs/8448/8879916/9904c3f4fe2c/polymers-14-00723-g005.jpg
https://cdn.ncbi.nlm.nih.gov/pmc/blobs/8448/8879916/f42493b0c44f/polymers-14-00723-g006.jpg
https://cdn.ncbi.nlm.nih.gov/pmc/blobs/8448/8879916/36add430e35c/polymers-14-00723-g007.jpg
https://cdn.ncbi.nlm.nih.gov/pmc/blobs/8448/8879916/7dfee1ed68be/polymers-14-00723-g008.jpg
https://cdn.ncbi.nlm.nih.gov/pmc/blobs/8448/8879916/43e5e5ac4c76/polymers-14-00723-g009.jpg
https://cdn.ncbi.nlm.nih.gov/pmc/blobs/8448/8879916/1340e4ece265/polymers-14-00723-g010.jpg

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Births: Final Data for 2018.出生情况：2018年最终数据。
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