{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,5,21]],"date-time":"2026-05-21T08:16:16Z","timestamp":1779351376382,"version":"3.51.4"},"reference-count":32,"publisher":"Wiley","issue":"1","license":[{"start":{"date-parts":[[2020,11,8]],"date-time":"2020-11-08T00:00:00Z","timestamp":1604793600000},"content-version":"vor","delay-in-days":0,"URL":"http:\/\/onlinelibrary.wiley.com\/termsAndConditions#vor"}],"content-domain":{"domain":["onlinelibrary.wiley.com"],"crossmark-restriction":true},"short-container-title":["Numer Methods Biomed Eng"],"published-print":{"date-parts":[[2021,1]]},"abstract":"<jats:title>Abstract<\/jats:title><jats:p>During vaginal delivery, the fetal head molds into an elongated shape to adapt to the birth canal, a process known as fetal head molding. However, excessive molding can occur due to prolonged labor or strong contractions, leading to several disorders on the fetal head. This work aims to perform a numerical study on the biomechanics of fetal head molding by measuring specific diameters and the corresponding molding index. A finite element model of the pelvic floor muscles and the fetal body was used. The fetal head is composed of the skin and soft tissues, the skull with sutures and fontanelles, and the brain. The sutures and fontanelles were modeled with membrane elements and characterized by a visco\u2010hyperelastic constitutive model adapted to a plane stress state. Simulations were performed to replicate the second stage of labor in the vertex presentation and occipito\u2010anterior position. With the introduction of viscoelasticity to assess a time\u2010dependent response, a prolonged second stage of labor resulted in higher molding. The pressure exerted by the birth canal and surrounding structures, along with the presence of the pelvic floor muscles, led to a percentage of molding of 9.1%. Regarding the pelvic floor muscles, a 19.4% reduction on the reaction forces and a decrease of 2.58% in muscle stretching was reported, which indicates that sufficient molding may lead to fewer injuries. The present study demonstrates the importance of focusing on the fetus injuries with non\u2010invasive methods that can allow to anticipate complications during labor.<\/jats:p>","DOI":"10.1002\/cnm.3411","type":"journal-article","created":{"date-parts":[[2020,11,1]],"date-time":"2020-11-01T12:02:22Z","timestamp":1604232142000},"update-policy":"https:\/\/doi.org\/10.1002\/crossmark_policy","source":"Crossref","is-referenced-by-count":16,"title":["A numerical study on fetal head molding during labor"],"prefix":"10.1002","volume":"37","author":[{"ORCID":"https:\/\/orcid.org\/0000-0003-3042-9257","authenticated-orcid":false,"given":"Rita","family":"Moura","sequence":"first","affiliation":[{"name":"Department of Mechanical Engineering Faculty of Engineering of the University of Porto  Porto Portugal"},{"name":"Division of Biomechanics INEGI \u2013 Institute of Science and Innovation in Mechanical and Industrial Engineering  Porto Portugal"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"ORCID":"https:\/\/orcid.org\/0000-0003-2410-2952","authenticated-orcid":false,"given":"Margarida","family":"Borges","sequence":"additional","affiliation":[{"name":"Department of Mechanical Engineering Faculty of Engineering of the University of Porto  Porto Portugal"},{"name":"Division of Biomechanics INEGI \u2013 Institute of Science and Innovation in Mechanical and Industrial Engineering  Porto Portugal"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"ORCID":"https:\/\/orcid.org\/0000-0003-3279-5285","authenticated-orcid":false,"given":"Maria C. P.","family":"Vila Pouca","sequence":"additional","affiliation":[{"name":"Division of Biomechanics INEGI \u2013 Institute of Science and Innovation in Mechanical and Industrial Engineering  Porto Portugal"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-8758-471X","authenticated-orcid":false,"given":"Dulce A.","family":"Oliveira","sequence":"additional","affiliation":[{"name":"Division of Biomechanics INEGI \u2013 Institute of Science and Innovation in Mechanical and Industrial Engineering  Porto Portugal"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-3326-6345","authenticated-orcid":false,"given":"Marco P. L.","family":"Parente","sequence":"additional","affiliation":[{"name":"Department of Mechanical Engineering Faculty of Engineering of the University of Porto  Porto Portugal"},{"name":"Division of Biomechanics INEGI \u2013 Institute of Science and Innovation in Mechanical and Industrial Engineering  Porto Portugal"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Nina","family":"Kimmich","sequence":"additional","affiliation":[{"name":"Division of Obstetrics University Hospital of Zurich  Zurich Switzerland"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-0979-4842","authenticated-orcid":false,"given":"Teresa","family":"Mascarenhas","sequence":"additional","affiliation":[{"name":"Department of Gynecology and Obstetrics, Centro Hospitalar de S\u00e3o Jo\u00e3o \u2010 EPE Faculty of Medicine of the University of Porto  Porto Portugal"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-7281-579X","authenticated-orcid":false,"given":"Renato M.","family":"Natal","sequence":"additional","affiliation":[{"name":"Department of Mechanical Engineering Faculty of Engineering of the University of Porto  Porto Portugal"},{"name":"Division of Biomechanics INEGI \u2013 Institute of Science and Innovation in Mechanical and Industrial Engineering  Porto Portugal"}],"role":[{"role":"author","vocabulary":"crossref"}]}],"member":"311","published-online":{"date-parts":[[2020,11,8]]},"reference":[{"key":"e_1_2_6_2_1","volume-title":"Williams Obstetrics","author":"Leveno KJ","year":"2018"},{"key":"e_1_2_6_3_1","doi-asserted-by":"publisher","DOI":"10.1515\/jpm-2016-0005"},{"key":"e_1_2_6_4_1","volume-title":"Current Diagnosis & Treatment: Obstetrics & Gynecology","author":"DeCherney A","year":"2007"},{"key":"e_1_2_6_5_1","doi-asserted-by":"publisher","DOI":"10.1016\/S0021-9290(01)00070-7"},{"key":"e_1_2_6_6_1","doi-asserted-by":"publisher","DOI":"10.15761\/NNR.1000112"},{"key":"e_1_2_6_7_1","doi-asserted-by":"publisher","DOI":"10.1111\/ocr.12106"},{"key":"e_1_2_6_8_1","doi-asserted-by":"publisher","DOI":"10.1017\/CBO9780511626722"},{"key":"e_1_2_6_9_1","doi-asserted-by":"publisher","DOI":"10.1016\/0020-7292(83)90081-4"},{"key":"e_1_2_6_10_1","unstructured":"BailetM ZaraF.Biomechanical model of the fetal head for interactive childbirth simulation. Paper presented at: SURGETICA 2014 Computer\u2010Assisted Medical Interventions: scientific problems tools and clinical applications. Dec.2014 pp.116\u2013119.https:\/\/hal.archives-ouvertes.fr\/hal-01301093."},{"key":"e_1_2_6_11_1","doi-asserted-by":"publisher","DOI":"10.1016\/j.medengphy.2010.12.018"},{"key":"e_1_2_6_12_1","doi-asserted-by":"publisher","DOI":"10.1016\/j.jbiomech.2015.02.032"},{"key":"e_1_2_6_13_1","unstructured":"LoydAM.Studies of the Human Head from Neonate to Adult: an Inertial Geometrical and Structural Analysis with Comparisons to the ATD Head. PhD thesis. Durham: Duke University.2011."},{"key":"e_1_2_6_14_1","doi-asserted-by":"publisher","DOI":"10.1007\/s10237-016-0855-5"},{"key":"e_1_2_6_15_1","unstructured":"ParenteMPL.Biomechanics of the Pelvic Floor during Vaginal delivery. PhD thesis. 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