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Magnetic resonance imaging of the active second stage of labour: Proof of principle

  • Magnetic Resonance
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Abstract

Objective

To prove that magnetic resonance imaging of foetal anatomy during the active second stage of vaginal delivery is feasible.

Materials and methods

Initially, five pregnant volunteers around the 30th week of gestation were examined in an open MRI. Based on the findings, one vaginal delivery was acquired under real-time imaging. To monitor the birth status during image acquisition, an MR-compatible wireless cardiotocography (CTG) system was built. Single-shot sequence parameters were optimised to compensate motion artefacts during labour.

Results

Safety requirements to monitor the birth process under real-time MR imaging were met. High-resolution MR images were acquired immediately before and after delivery. In one patient, TSE single-shot cinematic sequences of the active second stage of labour were obtained. All sequences were adapted to tolerate movement of the mother and infant, as well as residual noise from the CTG. Furthermore, the MR imaging during labour showed only minor image artefacts.

Conclusion

CTG-monitored acquisition of MRI series during the active second stage of delivery is feasible. Image quality should allow various further studies to improve models for birth simulation as well as potential investigation of obstructed labour and obstetric complications.

Key Points

• The active second stage of obstetric delivery can be followed by MRI.

• Wireless cardiotocography allows monitoring of the foetus during MRI.

• It has potential applications in evaluation of late obstetric problems.

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Abbreviations

MRI:

Magnetic resonance imaging

bSSFP:

Balanced steady-state free precession

CTG:

Cardiotocography

DAQ:

Data acquisition

FFE:

Fast field echo

FHR:

Foetal heart rate

FM:

Foetal monitor

GUI:

Graphical user interface

GRE:

Gradient echo

toco:

Tocodynamometer

TSE:

Turbo spin echo

US:

Ultrasound

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Authors and Affiliations

  1. Department of Radiology, Charité University Hospital, Charitéplatz 1, 10117, Berlin, Germany

    F. V. Güttler, A. Heinrich, J. Rump, M. de Bucourt, B. Hamm & U. K. Teichgräber

  2. Philips GmbH Unternehmensbereich Healthcare, Lübeckertordamm 5, 20099, Hamburg, Germany

    B. Schnackenburg

  3. Department of Obstetrics, Charité University Hospital, Charitéplatz 1, 10117, Berlin, Germany

    C. Bamberg

Authors
  1. F. V. Güttler
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  2. A. Heinrich
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  3. J. Rump
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  4. M. de Bucourt
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  5. B. Schnackenburg
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  6. C. Bamberg
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  7. B. Hamm
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  8. U. K. Teichgräber
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Corresponding author

Correspondence to F. V. Güttler.

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Güttler, F.V., Heinrich, A., Rump, J. et al. Magnetic resonance imaging of the active second stage of labour: Proof of principle. Eur Radiol 22, 2020–2026 (2012). https://doi.org/10.1007/s00330-012-2455-9

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  • DOI: https://doi.org/10.1007/s00330-012-2455-9

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