Researchers have developed a software program called PREDIBIRTH that can identify potential problems with delivery of the baby in high-risk pregnancies. The human birth canal is curved and relatively narrow compared to the baby’s head, raising many possibilities for the baby to get “stuck” (dystocia) during delivery.
The program uses MRI scans of the mother with the fetus in the womb and creates a three-dimensional reconstruction of both the pelvis and the fetus along with 72 possible trajectories of the baby’s head through the birth canal to determine the likelihood of a normal delivery. It simulates all possible combinations of head’s flexion, rotation, and synclitism (parallelism between the planes of the fetal head and those of the maternal pelvis) to detect when dystocia is likely to occur.
The software was tested in 24 pregnant women who had clinical and/or sonographical suspicion of cephalopelvic disproportion. The percentage of possible combinations likely to result in successful delivery was calculated and the risk of dystocia was defined as high when the score was less than 25%, mildly favorable between 25 and 50%, and highly favorable when the score was greater than 50%.
Simulation predictions corresponded with reality in virtually all cases: 13 women who delivered normally all had a highly favorable score. Three women delivered by elective cesarean section, of which two presented with severe macrosomia and also had a high risk score, and one presented with a small pelvis and had a mildly favorable score. Five babies were delivered by emergency cesarean section, of which two had cardiac fetal rhythm abnormalities of which one had a mildly favorable score and the other one a favorable score, three had obstruction of labour and all had a high risk score. Three babies delivered with a vacuum extraction all had a mildly favorable score. The software could be used to decide which babies should be delivered by elective cesarean section reducing the risk of an emergency section. Results of the study were presented on Tuesday at the RSNA.