Investigating the possible role of placenta position in road accident consecutive foetal loss

The main objective of this study is to evaluate the possibility of using a numerical model of a pregnant woman to understand placenta injury mechanisms in car accident situations. As a first step, a finite element (FE) model was developed by adding a gravid uterus in the already available Radioss Humos _R full human body model. This numerical model was evaluated using a cadaver tests approach. Simulated and experimental gravid uterus kinematics were compared and found in good agreement. Indentation tests also were performed on fresh placenta specimens. A placenta FE segment was then implemented into the full pregnant body model at different locations. For a simulated frontal impact at moderate speed, the placenta position was not found to significantly influence the abruption risk. Our results illustrate the potential of numerical simulation to improve the description of injury mechanisms related to pregnant women, in particular the placenta abruption. Further work is, however, required to develop the experimental tests database used for the model validation, and to investigate sensibility to maternal morphology. car crash; numerical model; placenta abruption; foetal death; traum

Which Foetal-Pelvic Variables Are Useful for Predicting Caesarean Section and Instrumental Assistance

International audiencea narrow pelvic inlet had a greater risk for requiring CD. The most efficient variables for discrimination were the transverse diameter and foetal weight. The antero-posterior inlet and obstetric conjugate were considered in this model, with the former being a useful variable but not the latter. For the SVD versus IAD model, the most important variables were the foetal variables, particularly the bi-parietal diameter. Women with a reduced antero-posterior outlet diameter and a narrow pubic arch were more at risk of requiring an IAD. Conclusion: The antero-posterior inlet was an efficient variable unlike the obstetric conjugate. The obstetric conjugate diameter should no longer be considered a useful variable in estimating the arrest of labour. Antero-posterior inlet diameter was a sagittal variable that should be taken into account. The comparison of sub-pubic angle and bi-parietal and antero-posterior outlet diameters was useful in identifying a risk of requiring instrumental assistance. Abstract Objective: To assess the variables useful to predict caesare-an delivery (CD) and instrumental assistance, through the analysis of a large number of foetal-pelvic variables, using discriminant analysis. Materials and Methods: One hundred and fourteen pregnant women were included in this single-centre prospective study. For each mother-foetus pair, 43 pelvic and 18 foetal variables were measured. Partial least squares-discriminant analysis was performed to identify foe-tal-pelvic variables that could statistically separate the 3 delivery modality groups: spontaneous vaginal delivery (SVD), CD, and instrument-assisted delivery (IAD). Results: For the SVD versus CD model, voluminous foetuses and women wit

The PROMIS model to highlight the importance of the foetus to the validation of a pregnant woman model

The percentage of trauma during pregnancy related to road accident is between 50% and 75%. This type of trauma can result in premature birth or even foetal loss. To analyse and understand the injury mechanisms in pregnant women involved in a car accident, several studies proposed computational or physical tools to simulate accidents. Specific dummy and numerical models have been proposed and validated using experimental data from post-mortem human surrogate (PMHS) scaled with the equal-stress, equal-velocity scaling method to a pregnant woman. This study proposes to evaluate the reliability of this assumption and its scope

Comparaison de deux protocoles antalgiques utilisés au cours de la ponction folliculaire sur les taux de réussite en fécondation in vitro

Objectives: Analgesic protocols administered before a follicular puncture under local anesthesia are well tolerated when using NSAIDs, but we still do not know their possible impacts on in vitro fertilization (IVF) outcomes. Material and methods: A retrospective monocentric study using two consecutive temporal cohorts of patients was conducted to compare two analgesic protocols: paracetamol/alprazolam (P/A), then nefopam/ketoprofen (N/K). Results: We demonstrated that biochemical pregnancy rate and the others outcomes of IVF are not significantly influenced by the type of analgesic protocol used. Conclusion: The protocol N/K enhances patient comfort without jeopardizing the IVF success rates. © 2010 Elsevier Masson SAS. All rights reserved

Three-dimensional Finite Element Modeling of an Uterus Surgery

International audienc