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. 2013 Nov 6:10:64.
doi: 10.1186/1742-4682-10-64.

Computer simulation of cervical tissue response to a hydraulic dilator device

Nenad Filipovic  1 , Dalibor Nikolic, Igor Saveljic, Irena Tanaskovic, Nebojsa Zdravkovic, Aleksandar Zivanovic, Petar Arsenijevic, Branislav Jeremic, Slobodan Arsenijevic
Affiliations

Computer simulation of cervical tissue response to a hydraulic dilator device

Nenad Filipovic et al. Theor Biol Med Model. .

Abstract

Background: Classical mechanical dilators for cervical dilation are associated with various complications, such as uterine perforation, cervical laceration, infections and intraperitoneal hemorrhage. A new medical device called continuous controllable balloon dilator (CCBD) was constructed to make a significant reduction in all of the side effects of traditional mechanical dilation.

Method: In this study we investigated numerically the cervical canal tissue response for Hegar and CCBD using our poroelastic finite element model and in-house software development. Boundary conditions for pressure loading on the tissue for both dilators in vivo were measured experimentally. Material properties of the cervical tissue were fitted with experimental in vivo data of pressure and fluid volume or balloon size.

Results: Obtained results for effective stresses inside the cervical tissue clearly showed higher stresses for Hegar dilator during dilation in comparison with our CCBD.

Conclusion: This study opens a new avenue for the implementation of CCBD device instead of mechanical dilators to prevent cervical injury during cervical dilation.

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Figures

Figure 1
Figure 1
CCBD and main constituens of human cervical extracellular matrix.
Figure 2
Figure 2
Ballon shape during dilation process of cervix canal in-vivo for different time. Pressure and volume of dilation for CCBD in time.
Figure 3
Figure 3
Pressure measurement in-vitro (Pa), in vivo (Pb) and total pressure from dilator to the cervical canal tissue (Pa-Pb).
Figure 4
Figure 4
Computational model of cervical canal. The part which is zoomed presents the tissue in cylindrical shape where the boundary condition is the pressure loading from dilator; a) Case with CCBD; b) Case with Hegar dilator.
Figure 5
Figure 5
Displacement radial distribution of cervical tissue canal for CCBD (left panel) and Hegar dilator (right panel) in time; a) Displacement after 5 sec; b) Displacement after 20 sec; c) Displacement after 35 sec; d) Displacement after 45 sec.
Figure 6
Figure 6
Effective stress distribution for cervical tissue canal for CCBD (left panel) and Hegar dilator (right panel) in time. a) Effective stress after 5 sec; b) Effective stress after 20 sec; c) Effective stress after 35 sec; d) Effective stress after 45 sec.
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