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Mathematical Dynamic Modeling (MADYMO) of the Maternal Pelvis and Neonate for Studying the Effects of McRoberts and Neonate-focused Maneuvers During Shoulder Dystocia and Delivery
Bakhri, Rania Nurita
Bakhri, Rania Nurita
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Thesis/Dissertation
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2025-05
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Bioengineering
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https://doi.org/10.34944/94c8-vf93
Abstract
During childbirth, the anterior fetal shoulder can get caught behind the maternal pelvis, resulting in shoulder dystocia (SD). The most common injury associated with SD is brachial plexus (BP) injury. Such birthing scenarios can also lead to neonatal hypoxia. The BP is a network of nerves located bilaterally from the C5 to T1 vertebrae and provides innervation to the upper extremity (shoulders, arms, and hands). During delivery, maternal forces contribute to the pushing of the neonate out of the birth canal. However, during shoulder dystocia the constant push forces increase the angle between the shoulder and the axis of the neck, leading to BP stretch injury or Neonatal Brachial Plexus Palsy (NBPP). NBPP is usually temporary but can be permanent in rare instances. Computational modeling can be used to investigate the effects of birthing maneuvers and delivery forces on BP stretch, as studying BP injury in a clinical setting has ethical limitations. Trials were conducted using normal and hypoxic BP stretch data (in vivo and in vitro) to investigate differences in strain. Results from such modeling can help provide the data needed to provide clinicians with clinical training tools in the future.
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