PDF(Pubmed)
Abstract：
Reducing failed labor and emergency cesarean section (CS) rates is an important goal. A childbirth simulation tool (PREDIBIRTH software and SIM37 platform) that evaluates a 5-min magnetic resonance imaging (MRI) assessment performed at 37 weeks of gestation was developed to enhance the consulting obstetrician\'s ability to predict the optimal delivery mode. We aimed to determine the potential value of this childbirth simulation tool in facilitating the selection of an optimal delivery mode for both mother and infant. A retrospective cohort study was performed on all patients referred by their obstetricians to our level 2 maternity radiology department between December 15, 2015 and November 15, 2016, to undergo MRI pelvimetry at approximately 37 weeks of gestation. The childbirth simulation software was employed to predict the optimal delivery mode based on the assessment of cephalopelvic disproportion. The prediction was compared with the actual outcome for each case. Including childbirth simulations in the decision-making process had the potential to reduce emergency CSs, inappropriately scheduled CSs, and instrumental vaginal deliveries by up to 30.1%, 20.7%, and 20.0%, respectively. Although the use of the simulation tool might not have affected the overall CS rate, consideration of predicted birthing outcomes has the potential to improve the allocation between scheduled CS and trial of labor. The routine use of childbirth simulation software as a clinical support tool when choosing the optimal delivery mode for singleton pregnancies with a cephalic presentation could reduce the number of emergency CSs, insufficiently justified CSs, and instrumental deliveries.
摘要：
降低失败的分娩率和紧急剖宫产（CS）率是重要目标。开发了一种分娩模拟工具（PREDIBIRTH软件和SIM37平台），用于评估妊娠37周时进行的5分钟磁共振成像（MRI）评估，以增强咨询产科医生预测最佳分娩方式的能力。我们旨在确定此分娩模拟工具在促进为母婴选择最佳分娩方式方面的潜在价值。在2015年12月15日至2016年11月15日期间，对产科医生转诊到我们的2级产科放射科的所有患者进行了回顾性队列研究，以在妊娠约37周时进行MRI骨盆测量。在评估头盆不称的基础上，采用模拟分娩软件预测最佳分娩方式。将预测与每种情况的实际结果进行比较。在决策过程中包括分娩模拟，有可能减少紧急CSs，调度不当的CS，和工具性阴道分娩高达30.1%，20.7%,和20.0%，分别。尽管模拟工具的使用可能不会影响整体CS速率，考虑预测的分娩结果有可能改善计划CS和分娩试验之间的分配。在选择具有头颅表现的单胎妊娠的最佳分娩模式时，常规使用分娩模拟软件作为临床支持工具可以减少紧急CSs的数量。不充分合理的CS，和工具性交付。
