Advances in Perinatal Medicine pp 295-356 | Cite as
Effects of Uterine Contractility on the Fetal Cranium
Abstract
The obstetrical literature is filled with studies that examine empirical relationships between the strength of uterine contractions and the progress of labor. Furthermore, there are numerous statistical studies that present retrospective relationships between perinatal outcome and intrapartum factors such as length of labor, method of delivery, and fetal heart rates. But relatively little has been written about the direct effects of uterine contractility on the fetus. Indeed, observations have been made to demonstrate that sometimes relationships exist between uterine function and secondary measures of fetal well-being such as fetal heart rate or postpartum fetal skull molding, but the pathophysiology of such fetal responses are usually left to conjecture. This chapter examines the direct effects of uterine contractility on the fetal cranium and attempts to explain how the intrapartum assessment of these effects could help in the safe management of parturition.
Keywords
Cerebral Palsy Occipital Bone Parietal Bone Head Shape Cranial BonePreview
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References
- 1.Kelly, J. V., 1963, Compression of the fetal brain, Am. J. Obstet. Gynecol. 85(5):687.PubMedGoogle Scholar
- 2.Glenting, P., 1970, Etiology of Congenital Spastic Palsy, F.A.D.L. s Forlag, Coppenhagan.Google Scholar
- 3.Willerman, L., 1970, Maternal pelvic size and neuropsychological outcome, in: Physical Trauma as an Etiological Agent in Mental Retardation (C. R. Angle and E. A. Bering, eds.), pp. 109–112, U.S. Department of Health, Education, and Welfare, Washington, D.C.Google Scholar
- 4.Fianu, S., 1976, Fetal mortality and morbidity following breech delivery, Acta Obstet. Gynecol. Scand. Suppl. 51:1.Google Scholar
- 5.Naeye, R. L., 1977, Causes of perinatal mortality in the U.S. collaborative perinatal project, JAm. Med. Assoc. 238:228.CrossRefGoogle Scholar
- 6.Wigglesworth, J. S., and Husemeyer, R. P., 1977, Intracranial birth trauma in vaginal breech delivery: The continued importance of injury to the occipital bone, Br. J. Obstet. Gynaecol. 84:684.PubMedGoogle Scholar
- 7.Quilligan, E. J., and Paul, R. H., 1975, Fetal monitoring: Is it worth it? Obstet. Gynecol. 45(1):96.PubMedGoogle Scholar
- 8.Berendes, H. W., 1975, The epidemiology of perinatal injury, in: Preventability of Perinatal Injury (K. Adamsons and H. A. Fox, eds.), p. 7, Liss, New York.Google Scholar
- 9.Hon, E. H., 1970, Trauma of labor, in: Physical Trauma as an Etiological Agent in Mental Retardation (C. R. Angle and E. A. Bering, eds.), pp. 151–161, U.S. Department of Health, Education, and Welfare, Washington, D.C.Google Scholar
- 10.Willerman, L., 1970, Fetal head position during delivery, and intelligence, in: Physical Trauma as an Etiologial Agent in Mental Retardation (C. R. Angle and E. A. Bering, eds.), pp. 105–108, U.S. Department of Health, Education, and Welfare, Washington, D.C.Google Scholar
- 11.Rosenbaum, A. L., 1970, Neuropsychologic outcome of children born via the occiput posterior position, in: Physical Trauma as an Etiological Agent in Mental Retardation (C. R. Angle and E. A. Bering, eds.), pp. 113–116, U.S. Department of Health, Education, and Welfare, Washington, D.C.Google Scholar
- 12.Clifford, S. H., and Drorbaugh, J. E., 1970, Obstetric history of grossly retarded children in the Boston sample of the collaborative study, in: Physical Trauma as an Etiological Agent in Mental Retardation (C. R. Angle and E. A. Bering, eds.), pp. 93–99, U.S. Department of Health, Education, and Welfare, Washington, D.C.Google Scholar
- 13.Friedman, E. A., Sachtleben, M. R., and Bresky, P. A., 1977, Dysfunctional labor: XII. Long-term effects on infant, Am. J. Obstet. Gynecol. 127(7):779.PubMedGoogle Scholar
- 14.Willson, J. R., 1979, Personal communication.Google Scholar
- 15.Todd, W. D., and Steer, C. M., 1963, Term breech: Review of 1006 term breech deliveries, Obstet. Gynecol. 22(5):583.PubMedGoogle Scholar
- 16.Mayer, P. S., and Wingate, M. B., 1978, Obstetric factors in cerebral palsy, Obstet. Gynecol. 51(4):399.PubMedCrossRefGoogle Scholar
- 17.Birch, H. G., Richardson, S. A., Baird, D., et al., 1970, Mental Subnormality in the Community, Williams and Wilkins, Baltimore, Md.Google Scholar
- 18.Cohen, W. R., 1977, Influence of the duration of second stage labor on perinatal outcome and puerperal morbidity, Obstet. Gynecol. 49(3):266.PubMedGoogle Scholar
- 19.Haberkern, C. M., Smith, D. W., and Jones, K. L., 1979, The breech head and its relevance, Am. J. Dis. Child. 133:154.PubMedGoogle Scholar
- 20.Durkin, M. V., Kaveggia, E. G., Pendleton, E., et al., 1976, Analysis of etiologic factors in cerebral palsy with severe mental retardation: I. Analysis of gestational, parturitional and neonatal data, Eur. J. Pediatr. 123:67.PubMedCrossRefGoogle Scholar
- 21.Friedman, E. A., 1973, Patterns of labor as indicators of risk, Clin. Obstet. Gynecol. 16:172.PubMedCrossRefGoogle Scholar
- 22.Lilienfeld, A. M., and Parkhurst, E., 1951, A study of the association of factors of pregnancy and parturition with the development of cerebral palsy, Am. J. Hyg. 53:262.PubMedGoogle Scholar
- 23.Eastman, N. J., and DeLeon, M., 1955, The etiology of cerebral palsy, Am. J. Obstet. Gynecol. 69:950.PubMedGoogle Scholar
- 24.Ball, R. P., and Marchbanks, S. S., 1935, Roentgen pelvimetry and fetal cephalometry: A new technique, Radiology 24:77.Google Scholar
- 25.Friedman, E. A., and Taylor, M. B., A modified nomographic aid for x—ray cephalopelvimetry, Am. J. Obstet. Gynecol. 105(7): 1110.Google Scholar
- 26.Kelly, K. M., Madden, D. A., Arcarese, J. S., et al., The utilization and efficacy of pelvimetry, Am. J. Roentgenol. 125(1):66.Google Scholar
- 27.Klapholz, H., 1975, A computerized aid to Ball pelvimetry, Am. J. Obstet. Gynecol. 121(8):1067.PubMedGoogle Scholar
- 28.Friedman, E. A., A prerecorded program for the Ball pelvimetry technique, Am. J. Obstet. Gynecol. 126(4):477.Google Scholar
- 29.Cianfrani, T., 1960, A Short History of Obstetrics and Gynecology, C. C. Thomas, Springfield, Ill.Google Scholar
- 30.Schwartz, P., 1961, Birth Injuries of the Newborn, Hafner, New York.Google Scholar
- 31.Swayne, J. G., 1867, Changes in the shape of the foetal head produced by labor, Br. Med. J. 5:768.CrossRefGoogle Scholar
- 32.Murray, R. M., 1888, On the effects of compression of the foetal skull, with special reference to delivery in minor degrees of flat pelvis, Edinburgh Med. J. 34:417.Google Scholar
- 33.Ballantyne, J. W., 1890, The head of the infant at birth, Edinburgh Med. J. 36:97.Google Scholar
- 34.Stumpf, M., 1907, Beitrag zur Kenntniss der Beeinflussing der Kopfform durch die Geburtsvorgange, Arch. Gynaekol. 82:215.CrossRefGoogle Scholar
- 35.Holland, E., 1922, Cranial stress in the foetus during labour and on the effects of excessive stress on the intracranial contents, with an analysis of eighty—one cases of torn tentorium cerebelli and subdural cerebral hemorrhage, J. Obstet. Gynaecol. Br. Emp. 29:549.CrossRefGoogle Scholar
- 36.Greenwood, W. O., 1924, Moulding of the foetal head and its consequences, J. Obstet Gynaecol. Br. Emp. 31:611.CrossRefGoogle Scholar
- 37.Moloy, H. C, 1942, Studies of head molding during labor, Am. J. Obstet. Gynecol. 44:762.Google Scholar
- 38.Baxter, J., 1946, Moulding of the foetal head: A compensatory mechanism,J. Obstet. Gynaecol. Br. Emp. 53:212.PubMedCrossRefGoogle Scholar
- 39.Ortiz, M. H., and Brodie, A.G., 1949, On the growth of the human head from birth to the third month of life, Anat. Rec. 103:311.PubMedCrossRefGoogle Scholar
- 40.Bordi, U., and Fernstrom, I., 1958, Die Umformung des kindlichen Kopfes während normaler Entbindungen in regelrechter Hinterhauptslag, Geburtshilfe Frauenheilkd. 18:1156.Google Scholar
- 41.Borell, U., and Fernstrom, I., 1958, Die Umformung des kindlichen Kopfes bei engem Becken, Geburtschilfe Frauenheilkd. 18:1245.Google Scholar
- 42.Borell, U., and Fernstrom, I., 1959, X—ray diagnosis of muscular spasm in the lower part of the uterus from the degree of moulding of the fetal head, Acta Obstet. Gynecol. Scand. 38:181.PubMedCrossRefGoogle Scholar
- 43.Borell, U., and Fernstrom, I., 1960, The mechanisms of labor in face and brow presentation, Acta Obstet. Gynecol. Scand. 39:626.PubMedCrossRefGoogle Scholar
- 44.Lindgren, L., 1960, The causes of foetal head moulding in labour, Acta Obstet. Gynecol. Scand. 39:46.PubMedCrossRefGoogle Scholar
- 45.Schwarcz, R. L., Strada-Saenz, G., Althabe, O., et al., 1970, Compression received by the head of the human fetus during labor, in: Physical Trauma as an Etiological Agent in Mental Retardation (C. R. Angle and E. A. Bering, eds.), pp. 133–141, U.S. Department of Health, Education, and Welfare, Washington, D.C.Google Scholar
- 46.Kriewall, T. J., Stys, S. J., and McPherson, G. K., 1977, Neonatal head shape after delivery: An index of molding, J. Perinatal Med. 5:260.CrossRefGoogle Scholar
- 47.De Souza, S. W., Ross, J., and Milner, R. D. G., 1976, Alterations in head shape of newborn infants after cesarean section or vaginal delivery, Arch. Dis. Child. 51:624.PubMedCrossRefGoogle Scholar
- 48.Kubli, F., 1977, Risk of vaginal breech delivery, Contrib. Gynecol. Obstet. 3:80.PubMedGoogle Scholar
- 49.Evans, F. G., and Lissner, H. R., 1957, Tensile and compressive strength of human parietal bone,J. Appl. Physiol. 10:493.PubMedGoogle Scholar
- 50.McElhaney, J. H., Fogle, J. L., Melvin, J. W., et al., 1970, Mechanical properties of cranial bone,J. Biomech. 3:495.PubMedCrossRefGoogle Scholar
- 51.Melvin, J. W., Robbine, D. H., and Roberts, V. L., 1969, The mechanical behavior of the diploe layer of the human skull in compression, Proc. 11th Midwestern Mechanics Conf. 5:811.Google Scholar
- 52.Scammon, R. E., and Calkins, L. A., 1929, The Development and Growth of the External Dimensions of the Human Body in the Fetal Period, University of Minnesota Press, Minneapolis.Google Scholar
- 53.McPherson, G. K., and Kriewall, T. J., 1980, The elastic modulus of fetal cranial bone: A first step towards an understanding of the biomechanics of fetal head molding, J. Biomech. 13(1):9–16.PubMedCrossRefGoogle Scholar
- 54.McPherson, G. K., and Kriewall, T. J., 1980, Fetal head molding: An investigation utilizing a finite element model of the fetal parietal bone,J. Biochem. 13(1): 17–26.Google Scholar
- 55.Roark, R. J., 1965, Formulas for Stress and Strain, 4th ed., McGraw—Hill, New York.Google Scholar
- 56.Burdi, A. R., 1978, Personal communication.Google Scholar
- 57.Dempster, W. T., 1967, Correlation of types of cortical grain structure with architectural features of human skull, Am. J. Anat. 120:7.CrossRefGoogle Scholar
- 58.Zienkiewicz, O. C., 1971, The Finite Element Method in Engineering Science, McGraw—Hill, New York.Google Scholar
- 59.Roark, R. J., 1965, Formulas for Stress and Strain, 4th ed., McGraw—Hill, New York.Google Scholar
- 60.Fung, Y. C, 1972, Stress—strain history relations of soft tissues in simple elongation, in: Biomechanics (Y. C. Fung, M. Perrone, and A. Anliker, eds.), pp. 181–208, Prentice—Hall, Englewood Cliffs, N.J.Google Scholar
- 61.Sedlin, E. D., 1965, A rheologic model for cortical bone, Acta Orthop. Scand. Suppl. 83.Google Scholar
- 62.Wood, J. L., 1971, Dynamic response of human cranial bone, J. Biomech. 4:1.PubMedCrossRefGoogle Scholar
- 63.Currey, T. D., 1969, The mechanical consequences of variation in the mineral content of bone,J. Biomech. 2:1.PubMedCrossRefGoogle Scholar
- 64.Dalen, J., Hellstrom, L., and Jacobson, B., 1976, Bone mineral content and mechanical strength of femoral neck, Acta Orthop. Scand. 47:503.PubMedCrossRefGoogle Scholar
- 65.Wall, J. C, Chatterji, S., and Jeffery, J. W., 1972, Human femoral cortical bone: A preliminary report on the relationship between strength and density, Med. Biol. Eng. 10:673.PubMedCrossRefGoogle Scholar
- 66.Wright, T. M., and Hayes, W. C, 1976, Tensile testing of bone over a wide range of strain rates: Effects of strain rate, microstructure and density, Med. Biol. Eng. 14:671.PubMedCrossRefGoogle Scholar
- 67.Mather, B. S., 1968, The effect of variation in specific gravity and ash content on the mechanical properties of human compact bone, J. Biomech. 1:207.CrossRefGoogle Scholar
- 68.Hubbard, R. P., 1971, Flexure of layered cranial bone,J. Biomech. 4:251.PubMedCrossRefGoogle Scholar
- 69.Hellman, L. M., and Pritchard, J. A., 1971, William’s Obstetrics, 14th ed., Appleton—Century—Crofts, New York.Google Scholar
- 70.Bathe, K., Wilson, E. L., and Peterson, F. E., 1974, SAP IV, A Structural Analysis Program for Static and Dynamic Response of Linear Systems, University of California Report No. EERC—11, Berkeley, California.Google Scholar
- 71.Bell, F., 1972, Biomechanics of human parturition, Ph.D. thesis, The University of Stathclyde, Glasgow, Scotland.Google Scholar
- 72.Chasler, C. N., 1972, Atlas of Roentgen Anatomy of the Newborn and Infant Skull, p. 36, Warren H. Gree, Inc., St. Louis, Missouri.Google Scholar