ABSTRACT
Routine daily practice shows that successful vaginal delivery for women with suspected narrow pelvis or large fetus remains possible. We present a computer software for the detection of fetopelvic disproportion based on 3D vectorial reconstructions of the fetal head and maternal pelvis with simulation of head passage through the pelvis for collision detection. Three delivery simulations were generated from MR pelvimetry data in two patients, one with narrow pelvis and the other with macrosomic fetus. Based on the simulation, fetus size in both cases was appropriate for the pelvic size, but delivery simulation for the macrosomic fetus concluded that vaginal delivery was mechanically impossible. Further evaluation of this promising software on a larger patient population is necessary.
Subject(s)
Cephalopelvic Disproportion/diagnosis , Computer Simulation , Imaging, Three-Dimensional , Magnetic Resonance Imaging , Pelvimetry/methods , Prenatal Diagnosis , Software , Adult , Feasibility Studies , Female , Humans , Pregnancy , Prenatal Diagnosis/methodsSubject(s)
Computer Simulation , Delivery, Obstetric , Image Processing, Computer-Assisted/methods , Imaging, Three-Dimensional/methods , Magnetic Resonance Imaging/methods , Computer Graphics , Female , Fetus/anatomy & histology , Humans , Labor Presentation , Models, Anatomic , Pelvic Bones/anatomy & histology , Pregnancy , User-Computer InterfaceABSTRACT
Pandemic influenza A H1N1 2009 is a benign disease when infecting healthy adults, but it can lead to severe consequences in pregnant woman, for the fetus or its mother. The incidence of the disease is increasing strongly, and health authorities estimate that one third of the world population might be infected before the end of the winter. Diagnosis of infection with influenza virus H1N1 is suspected when a patient presents with the association of symptoms of the respiratory tract like sore throat, cough, or dyspnea, with general signs like fever, myalgias, or exhaustion. Diagnosis confirmation is obtained with nasopharyngeal swab and virus detection with molecular biology. This flu can lead to severe consequences for the pregnant woman and fetus. For this reason, it is advisable to treat pregnant women systematically by oseltamivir or zanamivir, and to treat preventively the pregnant woman in case of close contact with a suspected or confirmed infected person. Even if the management of influenza A H1N1 2009 infection during pregnancy relies on family physicians and gynecologists, every physician having in charge such cases should regularly update his knowledge regarding the evolution of the recommendations for the pandemic.
Subject(s)
Disease Outbreaks , Influenza A Virus, H1N1 Subtype , Influenza, Human/diagnosis , Influenza, Human/therapy , Pregnancy Complications, Infectious/virology , Antiviral Agents/therapeutic use , Female , France/epidemiology , Humans , Influenza A Virus, H1N1 Subtype/isolation & purification , Influenza, Human/epidemiology , Nasopharynx/virology , Oseltamivir/therapeutic use , Pregnancy , Pregnancy Complications, Infectious/diagnosis , Pregnancy Complications, Infectious/therapy , Zanamivir/therapeutic useSubject(s)
Anemia, Hemolytic, Congenital/diagnostic imaging , Diagnostic Errors , Nuchal Translucency Measurement , Pregnancy Complications/diagnostic imaging , Pregnancy Trimester, First , Adult , Diagnosis, Differential , Female , Humans , Infant , Infant, Newborn , Male , Pregnancy , Pregnancy Trimester, First/physiologySubject(s)
Abnormalities, Multiple/diagnosis , Beckwith-Wiedemann Syndrome/complications , Cerebellum/abnormalities , Abnormalities, Multiple/pathology , Adult , Autopsy , Beckwith-Wiedemann Syndrome/diagnosis , Beckwith-Wiedemann Syndrome/pathology , Cerebellum/pathology , Female , Humans , Pregnancy , Prenatal DiagnosisABSTRACT
The aim of this paper is to show the major role played by the new computerized imaging tools available today in the fields of morphology and anatomy. For anatomical studies or educational purpose, they enhance the classical techniques. The 3D reconstruction, already used in daily clinical practice, will be the basis for computation of validated volumetric protocols enhancing our diagnosis and prognosis means. It is also a fantastic educational tool: the interactivity makes it simple, efficient, attractive and easily accessible and diffusable. For the research, mathematical modeling of embryogenesis and morphogenesis using finite elements method will open new ways for biomecanics and a dynamic quantification approach.