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Studying the Effects of Shoulder Dystocia and Neonate-Focused Delivery Maneuvers On Brachial Plexus Strain: A Computational Study
Journal article   Open access   Peer reviewed

Studying the Effects of Shoulder Dystocia and Neonate-Focused Delivery Maneuvers On Brachial Plexus Strain: A Computational Study

Joy A. Iaconianni, Sriram Balasubramanian, Michele J. Grimm, Bernard Gonik and Anita Singh
Journal of biomechanical engineering, pp 1-30
20 Dec 2023
DOI: https://doi.org/10.1115/1.4064313
PMID: 38116838
Featured in Collection :   UN Sustainable Development Goals @ Drexel
url
https://www.ncbi.nlm.nih.gov/pmc/articles/PMC10880949View
Published, Version of Record (VoR)Open Access (License Unspecified),  Open
url
https://doi.org/10.1115/1.4064313View
Published, Version of Record (VoR) Open

Abstract

The purpose of this computational study was to investigate the effects of neonate-focused clinical delivery maneuvers on brachial plexus (BP) during shoulder dystocia. During shoulder dystocia, the anterior shoulder of the neonate is obstructed behind the symphysis pubis of the maternal pelvis, post-delivery of the neonate's head. This is managed by a series of clinical delivery maneuvers. The goal of this study was to simulate these delivery maneuvers and study their effects on neonatal BP strain. Using MADYMO models of a maternal pelvis and a 90th-percentile neonate, delivery maneuvers and positions were simulated including the lithotomy position alone of the maternal pelvis, delivery with the application of various suprapubic pressures (SPPs), neonate in an oblique position, and during posterior arm delivery maneuver. The resulting BP strain (%) along with the required maternal delivery force were reported in these independently simulated scenarios. The lithotomy position alone served as the baseline. Each of the successive maneuvers reported a decrease in the required delivery force and resulting neonatal BP strain. As the applied SPP force increased, the required maternal delivery force and neonatal BP strain decreased. A further decrease in both delivery force and neonatal BP strain was observed in the oblique position, with the lowest delivery force and neonatal BP strain reported during the posterior arm delivery maneuver. Data obtained from the improved computational models in this study enhances our understanding of the effects of clinical maneuvers on neonatal BP strain during complicated birthing scenarios such as shoulder dystocia.

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13 Record Views
2 citations in Web of Science
2 citations in Scopus

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UN Sustainable Development Goals (SDGs)

This publication has contributed to the advancement of the following goals:

#3 Good Health and Well-Being
#5 Gender Equality

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Collaboration types
Domestic collaboration
Web of Science research areas
Biophysics
Engineering, Biomedical
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