Millions of years of humans having babies have still not liberated women from childbirth complications that can endanger both mother and child. Now pregnant women could get relief from a new simulator that predicts difficult deliveries ahead of time by using medical scans of babies in the womb.
The software converts magnetic resonance imaging (MRI) of pregnant women into 3D virtual simulations of the pelvis and fetus, and creates a score for each mother's chance of having a normal birth by calculating 72 possible paths for the baby's head to pass through the mother's birth canal. Physicians can then use the score to plan ahead for a cesarean section (C-section), rather than rush to perform one during an emergency.
"An emergency C-section has six to seven times more morbidity and mortality than a planned C-section," said Olivier Ami, an obstetrician at Antoine Beclere's Hospital, University Paris Sud, France. "With this virtual childbirth software, the majority of C-sections could be planned rather than emergency, and difficult instrumental extractions might disappear in the near future."
Ami and colleagues tested the software, called PREDIBIRTH, by blindly computing the delivery outcomes for 24 women who had already given birth. The program's predictions proved much more accurate than the existing method of pelvimetry, which predicts childbirth difficulty based upon manual measurements of the mother's pelvis.
"A small pelvis may be able to deliver without problems, and a big pelvis might require mechanical help during childbirth," Ami explained. "This uncertainty raises the rate of C-sections."
Thirteen women who received highly favorable PREDIBIRTH scores had normal deliveries, and three women assisted by vacuum extraction had mildly favorable simulator scores. Three women who chose to deliver by C-section scored at high risk for difficult labor — also known as dystocia.
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Of five women who underwent emergency C-sections, three who had problems delivering their babies also scored at high risk for dystocia. The remaining two women had received simulator scores deemed to be either mildly favorable or favorable, but their complications involved abnormal heart rhythms rather than problems with the birth canal.
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The software's success could help transform basic medical imaging into something with more predictive power. American physicians may also welcome it as a new tool, considering how C-sections make up one-third of all births in the United States.
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