Bone Abstracts

Mechanical stimulation generated by fetal kicking and movements is known to be important for prenatal musculoskeletal development. The most common human condition in which there is a link between abnormal fetal movements and delayed or impaired skeletal development is developmental dysplasia of the hip (DDH). DDH is a hip joint shape abnormality, with risk factors being associated with restricted fetal movement, such as fetal breech position and oligohydramnios. Evidence suggests that movements late in gestation are particularly important for normal hip joint development, as even short-term breech positioning at this stage is associated with an increased risk of DDH. We quantify the mechanical stimulation of the human fetal hip joint over gestation, for both normal and abnormal intrauterine environments, in order to investigate the link between a change in the biomechanics of the developing hip joint, and the risk of DDH after birth. We combined advanced fetal imaging with computational modelling techniques to predict the mechanical stimulation in the developing limb over the second half of gestation. Furthermore, we have modelled a range of intra-uterine conditions and situations which increase the risk of DDH, such as fetal breech position and oligohydramnios (reduced amniotic fluid), in order to be able to understand how a range of factors affecting movement may impact on the developing hip joint. We demonstrate that the stresses and strains acting in the hip joint are significantly reduced when a baby is in breech position, or suffers from oligohydramnios. We also reveal a trend of reduced stimulation in the joints of first-born children (who are also at a greater risk of DDH). Developmental biomechanics research can shed new light on the link between fetal movements and growth and morphogenesis, and thus inform future diagnostic and preventative measures for neonatal musculoskeletal conditions.

Disclosure: The author declared no competing interests.

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