Gunilla Ajne

Vacuum assisted delivery (VAD) is associated with significantly higher risk of fetal brain injury and maternal pelvic floor trauma compared to spontaneous vaginal delivery. Today, evidence for safe VAD is limited and accurate methods to evaluate VAD are lacking, which hinders development of safety. The goal of SAFEVAD is to advance biomechanical evidence and develop novel simulation and imaging tools to make VAD safer for both fetus and mother. We will develop a VAD testing platform that combines cutting-edge finite element models and physical phantoms of fetal head and pelvic floor muscles, to provide novel testing settings for VAD safety and performance. The testing platform will be used to i) establish biomechanical evidence for safe VAD, ii) optimize VAD in subject-specific VAD reconstructions, and iii) include novel approaches to guide safe VAD, such as monitoring of when imposed fetal brain deformations are exceeding safe levels, assessed by VAD-integrated miniature quantitative ultrasound. Additionally, ultrasound shear wave elastography (SWE) will be developed to improve assessment of VAD-related pelvic floor muscle injury, and provide accurate pelvic floor muscle mechanical properties for modelling. SAFEVAD is a 4-year project, which integrates multidisciplinary expertise in biomechanical modelling and imaging, obstetrics, fetal and pelvic floor medicine. Our highly related previous research provides a solid basis to initiate this project toward safer VAD.