A model for educational simulation of the effect of oxytocin on uterine contractions

Bastos, L.; Meurs, Willem L. van; Ayres-de-Campos, Diogo

doi:10.1016/j.medengphy.2012.06.021

Cited by 7 publications

(7 citation statements)

References 36 publications

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“…Basic assumptions are made, similar to the ones in the article of Bastos et al [3] and based on understanding of physiological relations, in order to keep the model as simple as possible, while approaching the target data of Zhang et al [6]. The subsystems and variables connecting them, as described in the introduction, are reflected in the block diagram of Fig.…”

Section: Methodsmentioning

confidence: 99%

“…For consistency, all values are given in three significant digitsSymbolDescriptionValueUnitReferenceP 1 Baseline oxytocin release rate in hypothalamus0.740mU/min[7]P 2 Gain from cervical dilation to oxytocin release rate in hypothalamus50.0mU/(min cm)P 3 Pharmacokinetic parameter: Elimination rate constant0.06931/min[3]P 4 Pharmacokinetic parameter: Volume of distribution18,700mL[8, 9]P 5 Maximal concentration frequency0.5001/min[2]P 6 Pharmacodynamic parameter: Oxytocin concentration resulting in 50% effect7.90mU/mL[3]P 7 Pharmacodynamic parameter: Slope of sigmoidal curve1.11dimensionless[2]P 8 Baseline contraction amplitude40.0mm Hg[10]P 9 Maximal contraction amplitude40.0mm Hg[2]P 10 Dilation increase due to pressure exerted by the fetus on the cervix1.00 × 10 −3 cm/min[11]P 11 Dilation increase due to contraction frequency and amplitude1.90 × 10 −2 cm/mm Hg…”

Section: Methodsmentioning

confidence: 99%

“…Simulators allow for practice of normal and critical situations at will and at no risk to real patients. Several models for educational simulation of labor and delivery were published in the literature [1–3] and incorporated into a commercially available training simulator [4]. The cited models make amplitude, frequency, duration, and resting tone of the uterine pressure waveform evolve spontaneously and under the influence of oxytocin and tocolytics.…”

Section: Introductionmentioning

confidence: 99%

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An empirical model for educational simulation of cervical dilation in first-stage labor

et al. 2018

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BackgroundSeveral 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.MethodsThe 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.ResultsSimulation 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.ConclusionAn 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.

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Section: Methodsmentioning

confidence: 99%

Section: Methodsmentioning

confidence: 99%

Section: Introductionmentioning

confidence: 99%

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An empirical model for educational simulation of cervical dilation in first-stage labor

et al. 2018

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“…Although not developed as a research tool, this work does show that models can be used to improve clinical management by providing healthcare practitioners with a realistic experience of changes in intrauterine pressure associated with complicated and normal labour. The model has since been extended to reflect specific clinical scenarios (Bastos et al, 2012) and to simulate the effect of oxytocin to augment labour (Lobo et al, 2013).…”

Section: Tissue Propagation Modelsmentioning

confidence: 99%

Computer models to study uterine activation at labour

Sharp

Saunders

Norman

2013

Molecular Human Reproduction

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Improving our understanding of the initiation of labour is a major aim of modern obstetric research, in order to better diagnose and treat pregnant women in which the process occurs abnormally. In particular, increased knowledge will help us identify the mechanisms responsible for preterm labour, the single biggest cause of neonatal morbidity and mortality. Attempts to improve our understanding of the initiation of labour have been restricted by the inaccessibility of gestational tissues to study during pregnancy and at labour, and by the lack of fully informative animal models. However, computer modelling provides an exciting new approach to overcome these restrictions and offers new insights into uterine activation during term and preterm labour. Such models could be used to test hypotheses about drugs to treat or prevent preterm labour. With further development, an effective computer model could be used by healthcare practitioners to develop personalized medicine for patients on a pregnancy-by-pregnancy basis. Very promising work is already underway to build computer models of the physiology of uterine activation and contraction. These models aim to predict changes and patterns in uterine electrical excitation during term labour. There have been far fewer attempts to build computer models of the molecular pathways driving uterine activation and there is certainly scope for further work in this area. The integration of computer models of the physiological and molecular mechanisms that initiate labour will be particularly useful.

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“…Augmented normal vaginal delivery depends on the infusion rate of augmented drugs, patient sensitivity to oxytocin and uterine response. Intense and/or frequent uterine contractions may be associated with decreased placental bed blood flow [5]. Cesarean section in comparison with vaginal delivery is usually associated with a reduction in placental perfusion and so poor iron-related hematologic indices in the cord and peripheral blood, which indicates that, neonates who delivered by cesarean section may be more likely to develop iron-deficiency anemia in infanthood [3].…”

Section: Introductionmentioning

confidence: 99%