TY - JOUR
T1 - An empirical model for educational simulation of cervical dilation in first-stage labor
AU - Gefferie, Silvano R.
AU - Scholten, Anouk W.J.
AU - Wijlens, Kim A.E.
AU - Ferraira Bastos, M. Luisa
AU - van der Hout-van der Jagt, M. Beatrijs
AU - Zwart, Hans
AU - van Meurs, Willem J.
PY - 2018/6/15
Y1 - 2018/6/15
N2 - Background: Several models for educational simulation of labor and delivery were published in the literature and incorporated into a commercially available training simulator (CAE Healthcare Lucina). However, the engine of this simulator does not include a model for the clinically relevant indicators: uterine contraction amplitude and frequency, and cervical dilation. In this paper, such a model is presented for the primigravida in normal labor.Methods: The conceptual and mathematical models represent oxytocin release by the hypothalamus, oxytocin pharmacokinetics, and oxytocin effect on uterine contractions, cervical dilation, and (positive) feedback from cervical dilation to oxytocin release by the hypothalamus.Results: Simulation results for cervical dilation are presented, together with target data for a normal primigravida. Corresponding oxytocin concentrations and amplitude and frequency of uterine contractions are also presented.Conclusion: An original empirical model for educational simulation of oxytocin concentration, uterine contractions, and cervical dilation in first-stage labor is presented. Simulation results for cervical dilation match target data for a normal patient. The model forms a basis for taking into account more independent variables and patient profiles and can thereby considerably expand the range of training scenarios that can be simulated.
AB - Background: Several models for educational simulation of labor and delivery were published in the literature and incorporated into a commercially available training simulator (CAE Healthcare Lucina). However, the engine of this simulator does not include a model for the clinically relevant indicators: uterine contraction amplitude and frequency, and cervical dilation. In this paper, such a model is presented for the primigravida in normal labor.Methods: The conceptual and mathematical models represent oxytocin release by the hypothalamus, oxytocin pharmacokinetics, and oxytocin effect on uterine contractions, cervical dilation, and (positive) feedback from cervical dilation to oxytocin release by the hypothalamus.Results: Simulation results for cervical dilation are presented, together with target data for a normal primigravida. Corresponding oxytocin concentrations and amplitude and frequency of uterine contractions are also presented.Conclusion: An original empirical model for educational simulation of oxytocin concentration, uterine contractions, and cervical dilation in first-stage labor is presented. Simulation results for cervical dilation match target data for a normal patient. The model forms a basis for taking into account more independent variables and patient profiles and can thereby considerably expand the range of training scenarios that can be simulated.
KW - Model
KW - First stage labor
KW - Oxitocin
KW - Uterine contractions
KW - Cervical dilation
KW - Educational simulation
U2 - 10.1186/s41077-018-0068-3
DO - 10.1186/s41077-018-0068-3
M3 - Article
SN - 2059-0628
VL - 3
JO - Advances in Simulation
JF - Advances in Simulation
M1 - 9
ER -