1、Pregnant Occupant Biomechanics Advances in Automobile Safety Research Edited by Stefan M. DumaPregnant Occupant Biomechanics - Advances in Automobile Safety Research Other SAE International books of interest: Forensic Biomechanics By Jeffrey A. Pike (Product Code R-379) Child Anthropometry for Impro
2、ved Vehicle Occupant Safety Edited by Matthew Reed and Kathleen Klinich (Product Code PT-142) Vehicle Accident Analysis and Reconstruction Methods, Second Edition By Raymond M. Brach and Matthew Brach (Product Code R-397) For more information or to order a book, contact SAE International: 400 Common
3、wealth Drive, Warrendale, PA 15096-0001 phone: 877-606-7323 (U.S. and Canada) or 724-776-4970 (outside U.S. and Canada) fax: 724-776-0790 e-mail: CustomerServicesae.org website: http:/store.sae.org Pregnant Occupant Biomechanics - Advances in Automobile Safety ResearchEdited by Stefan M. Duma Chapte
4、r Authors: Greg G. Duma Stefan M. Duma Melissa C. Hulse Kathleen D. Klinich Sarah J. Manoogian Jonathan D. Rupp Lawrence W. Schneider Joel D. Stitzel Published by SAE International 400 Commonwealth Drive Warrendale, PA 15096-0001 USA Phone: (724) 776-4841 Fax: (724) 776-5760 www.sae.org PT-150 April
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7、pyrightsae.org; phone: 724-772-4028; fax: 724-772-9765. ISBN 978-0-7680-4849-0 Library of Congress Catalog Number 2011922588 SAE Order No. PT-150 Information contained in this work has been obtained by SAE International from sources believed to be reliable. However, neither SAE International nor its
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12、t http:/store.sae.org Dedication To Chrissy, Lauren, and Brock For putting me on the pregnant occupant research path TABLE OF CONTENTS Chapter 1: Female Anatomy 3 Associated Paper: Loftis, K., M. Halsey, E. Anthony, S. M. Duma, and J. D. Stitzel. 2008. “Pregnant Female Anthropometry from CT Scans fo
13、r Finite Element Model Development,”Biomedical Sciences Instrumentation 44:355-360. . 23 Chapter 2: Maternal and Fetal Injury Incidence . 31 Associated Papers: Pearlman, M. D., J. E. Tintinalli, and R. P. Lorenz. 1989. “A Prospective Controlled Study of Outcome after Trauma During Pregnancy,” Americ
14、an Journal of Obstetrics and Gynecology 162(6):1502-1510. 45 Peckham, C. H. and R. W. King. 1963. “A Study of Intercurrent Conditions Observed During Pregnancy,” American Journal of Obstetrics and Gynecology 87(5):609-624 . 55 Chapter 3: Investigation and Analysis of Crashes Involving Pregnant Occup
15、ants . 73 Associated Papers: Klinich, K. D., L. W. Schneider, J. L. Moore, and M. D. Pearlman. 1998. “Injuries to Pregnant Occupants in Automotive Crashes,” In 42nd Annual Proceedings Association for the Advancement of Automotive Medicine, Charlottesville, VA, October 5-7. 57-91. 85 Klinich, K. D.,
16、L. W. Schneider, J. L. Moore, and M. D. Pearlman. 2000. “Investigation of Crashes Involving Pregnant Occupants,” In 44th Annual Proceedings Association for the Advancement of Automotive Medicine, Chicago, IL, October 2-4. 37-55 . 121 Klinich, K. D., C. A. C. Flannagan, J. R. Rupp, M. D. Sochor, L. W
17、. Schneider, and M. D. Pearlman. 2008. “Fetal Outcome in Motor-Vehicle Crashes: Effects of Crash Characteristics and Maternal Restraint,” American Journal of Obstetrics and Gynecology 198:450.e1-450.e9 141 Metz, T. D. and J. T. Abbott. 2006. “Uterine Trauma in Pregnancy after Motor Vehicle Crashes w
18、ith Airbag Deployment: A 30-Case Series,” Journal of Trauma 61(3):658-61. . 151 i Preface v Acknowledgments . vii Chapter 4: Pregnant Crash Test Dummies and Pregnant Occupant Anthropometry 157 Associated Papers: Motozawa, Y., T. Abe, M. Hitosugi, and S. Tokudome. 2009. “Analysis of Overall Kinematic
19、s and Abdominal Response of Pregnant Drivers during Frontal Vehicle Collisions,” SAE Paper No. 2009-01-0380. SAE International, Warrendale, PA . 169 Rouhana, S. W., A. M. Elhagediab, A. Walbridge, W. N. Hardy, and L. W. Schneider. 2001. “Development of a Reusable, Rate-Sensitive Abdomen for the Hybr
20、id III Family of Dummies,” Stapp Car Crash Journal 45:33-60 . . 179 Rupp, J. D., K. D. Klinich, S. Moss, J. Zhou, M. D. Pearlman, and L. W. Schneider. 2001. “Development and Testing of a Prototype Pregnant Abdomen for the Small-Female Hybrid III ATD,” Stapp Car Crash Journal 45:61-77. . 207 Chapter
21、5: Material Properties of Pregnant Tissues 227 Associated Papers: Hu, J., K. D. Klinich, C. S. Miller, G. Nazmi, M. D. Pearlman, L. W. Schneider, and J. D. Rupp. 2009. “Quantifying Dynamic Mechanical Properties of Human Placenta Tissue using Optimization Techniques with Specimen-Specific Finite-Elem
22、ent Models,” Journal of Biomechanics 42(15):2528-2534. 239 Manoogian, S. J., J. A. Bisplinghoff, C. McNally, A. R. Kemper, A. C. Santago, and S. M. Duma. 2008. “Dynamic Tensile Properties of Human Placenta,” Journal of Biomechanics 41:3436-3440 . . 247 Manoogian, S. J., C. McNally, J. D. Stitzel, an
23、d S. M. Duma. 2008. “Dynamic Biaxial Tissue Properties of Pregnant Porcine Uterine Tissue,” Stapp Car Crash Journal 52:167-185 253 Manoogian, S. J., J. A. Bisplinghoff, C. McNally, A. R. Kemper, A. C. Santago, and S. M. Duma. 2009. “Effect of Strain Rate on the Tensile Material Properties of Human P
24、lacenta,” Paper No. 091008. Journal of Biomechanical Engineering 131(9) 273 Yu, M., S. J. Manoogian, S. M. Duma, and J. D. Stitzel. 2009. “Finite Element Modeling of Human Placenta Tissue,” Annals of Advances in Automotive Medicine 53:257-270. . 279 Chapter 6: Computational Modeling of Pregnant Occu
25、pants 295 Associated Papers: Duma, S. M., D. M. Moorcroft, J. D. Stitzel, and G. G. Duma. 2004. “Evaluating Pregnant Occupant Restraints: The Effect of Local Uterine Compression on the Risk of Fetal Injury,” Annals of Advances in Automotive Medicine 48:103-114. . 305 Duma, S. M., H. C. Gabler, D. M.
26、 Moorcroft, S. J. Manoogian, J. D. Stitzel, and G. G. Duma. 2006. “Analysis of Pregnant Occupant Crash Exposure and the Potential Effectiveness of Four-Point Seatbelts in Far Side Crashes,” Annals of Advances in Automotive Medicine 50:187-198. 317 ii Moorcroft, D. M., S. M. Duma, J. D. Stitzel, and
27、G. G. Duma. 2003. “Computational Model of the Pregnant Occupant: Predicting the Risk of Injury in Automobile Crashes,” American Journal of Obstetrics and Gynecology 189(2):540-544. 329 Moorcroft, D. M., J. D. Stitzel, S. M. Duma, and G. G. Duma. 2004. “The Effect of Pregnant Occupant Position and Be
28、lt Placement on the Risk of Fetal Injury,” SAE Paper No. 2004-01-0324. Presented at SAE International Congress and Exposition, Detroit, MI, March . 335 About the Authors 341 iii PREFACE This book provides substantial new analysis and summary data for the field of pregnant occupant biomechanics. In a
29、ddition, full-length manuscripts of selected publications are included to augment the new materials. The overall goal of this book is to provide the reader with a complete resource for issues relating to the pregnant occupant. The target audience is anyone in the broad field of automobile safety inc
30、luding engineers, physicians, and others who are dedicated to advancing automobile safety. The book is divided into six chapters that were each authored separately by individual topic experts. The first three chapters set the foundation for the pregnant occupant problem, as the female anatomy, injur
31、y incidence, and case study are presented. The next three chapters present possible solutions in the form of pregnant dummies, tissue testing, and computational models. Each chapter begins with a summary and analysis of the research for that topic. Next, to provide depth and additional materials, a
32、selection of references is followed by selected full-length paper reproductions. This book will be a critical asset to anyone in the field of automobile safety. It will be of specific interest to safety design engineers, trauma physicians, OEM engineers, accident reconstruction specialists, occupant
33、 restraint suppliers, law enforcement officials, impact biomechanics researchers, and human factors specialists. Many government agencies will find this book useful, including the Department of Transportation (National Highway Traffic Safety Administration), the Department of Defense, and the Federa
34、l Aviation Administration. The authors of each chapter selected the papers to include based on the significance and long-term reference value of each paper. Once the papers were selected, permission was obtained to reproduce each manuscript. In a few cases with older papers, full reproductions were
35、not included due to inability to find high-quality copies of the original materials. v ACKNOWLEDGMENTS First, I want to thank Martha Swiss and SAE International for their invaluable assistance and for providing the forum for this important publication. Second, I thank all of the chapter authors for
36、taking the time to write, and assemble and review, their respective chapters. Finally, I thank Melissa Hulse for her effort in tracking down all of the copyright permissions as well as handling the review process with the separate chapter authors. It took nearly two years to complete, but this book
37、will serve our field for decades to come. I also want to acknowledge the Virginia Tech Wake Forest University School of Biomedical Engineering and Sciences for the financial support of this book. In addition, I thank the organizations that granted permission to reproduce their papers: Association fo
38、r the Advancement of Automotive Medicine, American Journal of Obstetrics and Gynecology, Biomedical Sciences Instrumentation, Journal of Biomechanics, Journal of Biomechanical Engineering, Journal of Trauma, Stapp Car Crash Journal, and SAE International. vii CHAPTER 1 FEMALE ANATOMY CHAPTER 1: FEMA
39、LE ANATOMY Greg G. Duma, Sarah J. Manoogian, Kathryn L. Loftis, Joel D. Stitzel, and Stefan M. Duma Virginia Tech Wake Forest University, Center for Injury Biomechanics Kathleen D. Klinich, Carl A. Miller, Jingwen Hu, Julia Samorezov, Jesse Buehler, Mark D. Pearlman, Lawrence W. Schneider, and Jonat
40、han D. Rupp University of Michigan Transportation Research Institute The pelvic anatomy of the female has been studied since recorded history. Female anatomy has developed many accommodations to facilitate child bearing. Not only are there the obvious differences in the external anatomy, but even ch
41、anges in the bony pelvic structure all aid in the birthing process. The pelvic anatomy of a female is somewhat complex and becomes more so in the state of pregnancy. This chapter is designed to be an overview for the student of engineering and is not meant to be a surgical atlas. NONPREGNANT ANATOMY
42、 Bony Pelvis The bony pelvis is similar, although not exactly the same, in males and females. The anatomy of the bones is slightly different to adapt for childbearing. The pelvic bones are made up of the ilium, ischium, pubis, sacrum, and coccyx. In the adult female, the hip bones are formed from th
43、e ilium, ischium, and pubic bones which are fused together with cartilage. The hip bones are fused anteriorly in the midline at the symphysis pubis and connected posteriorly via the sacrum and coccyx. The ischium supports the weight of the body while in the seated position with the weight resting on
44、 the ischial tuberosities. On the medial surface of the ilium is a structure known as the arcus tendineus. The muscles of the pelvic floor attach to the hip bones at this point. The sacrum and coccyx are extensions of the vertebra which have been fused. The most anterior portion of the sacrum is ter
45、med the sacral promontory. This landmark, palpable on a physical exam, is useful clinically as it represents the level where the internal iliacs divide, and is a point used in obstetrics to clinically assess the adequacy of the pelvis for labor. The ischial spines extend from the ischium, and the di
46、stance between the two represents the shortest diameter of the pelvis. This distance can be clinically measured to help assess risk of dystocia - difficult passage of the baby - during childbirth. The typical female has a gynecoid-shaped pelvis with the anterior and posterior portions being fairly e
47、qual and forming a round pelvic diameter. This pelvic shape facilitates the birth process. The wider subpubic angle and increased distance from the symphysis to the acetabulum, or hip bone fossa, allows for easier delivery of the fetus. Vagina and Cervix The vagina, or birth canal, is the tubular st
48、ructure connecting to the cervix. While in the standing position, the vagina lies in a horizontal plane. The cervix, attached to the uterus, extends into the vagina. Directly posterior to the cervix in the vagina, the tissue is thin. A needle can easily be 3passed through this thin tissue to enter i
49、nto the abdominal or peritoneal cavity. The peritoneal cavity contains the internal structures such as the uterus and ovaries, as well as the loops of intestine, etc. This area of the abdominal cavity is known as the posterior cul de sac, as it is a sac structure posterior to the uterus. Likewise, an incision made in the vagina at this point will allow a larger access into the abdominal cavity. Internal Organs The uterus is located in the lower pelvis in a nonpregnant female. It is situated between the bladder anteriorly, and the rectum posteriorly. The intraperitoneal space in
