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clee03m
Jul 27, 2009, 5:30 PM
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This is not a discussion as to whether a pregnant woman should or should not lead. Please--if you want to address this issue in a non-scientific way (such as calling a pregnant leader a pig), either post to previous threads or start another one.
I was doing some research into how much force is enough to cause placental abruption. I was hoping someone could translate some of this into useful numbers for climbing. Should have paid more attention is my physics classes...
From Pearlman et al:
Automobile crashes are the largest cause of injury death for pregnant females and the leading cause of traumatic fetal injury mortality in the United States. Computational models, useful tools to evaluate the risk of fetal loss in motor vehicle crashes, are based on a limited number of quasi-static material tests of the placenta. This study presents a total of 20 dynamic uniaxial tensile tests on the maternal side of the placenta and 10 dynamic uniaxial tensile tests on the chorion layer of the placenta. These tests were completed from 6 human placentas to determine material properties at a strain rate of 7.0 strains/s. The results show that the average peak strain at failure for both the maternal portion and the chorion layer of the placenta are similar with a value of 0.56 and 0.61, respectively. However, the average failure stress for the chorion layer, 167.8 kPa, is much higher than the average failure stress for the placenta with the chorionic plate removed, 18.6 kPa. This is due to differences in the structure and function of these layers in the placenta. In summary, dynamic loading data for the placenta have been determined for use in computational modeling of pregnant occupant kinematics in motor vehicle crashes. Moreover the computational model should utilize the material properties for the placenta without the chorion layer.
Thanks!
Christine
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limeydave
Jul 27, 2009, 5:57 PM
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clee03m wrote: This is not a discussion as to whether a pregnant woman should or should not lead. Please--if you want to address this issue in a non-scientific way (such as calling a pregnant leader a pig), either post to previous threads or start another one. I was doing some research into how much force is enough to cause placental abruption. I was hoping someone could translate some of this into useful numbers for climbing. Should have paid more attention is my physics classes... From Pearlman et al: Automobile crashes are the largest cause of injury death for pregnant females and the leading cause of traumatic fetal injury mortality in the United States. Computational models, useful tools to evaluate the risk of fetal loss in motor vehicle crashes, are based on a limited number of quasi-static material tests of the placenta. This study presents a total of 20 dynamic uniaxial tensile tests on the maternal side of the placenta and 10 dynamic uniaxial tensile tests on the chorion layer of the placenta. These tests were completed from 6 human placentas to determine material properties at a strain rate of 7.0 strains/s. The results show that the average peak strain at failure for both the maternal portion and the chorion layer of the placenta are similar with a value of 0.56 and 0.61, respectively. However, the average failure stress for the chorion layer, 167.8 kPa, is much higher than the average failure stress for the placenta with the chorionic plate removed, 18.6 kPa. This is due to differences in the structure and function of these layers in the placenta. In summary, dynamic loading data for the placenta have been determined for use in computational modeling of pregnant occupant kinematics in motor vehicle crashes. Moreover the computational model should utilize the material properties for the placenta without the chorion layer. Thanks! Christine
Good one!
Well, we work mostly in KN, and one KPa is 1 KN/m2 (one kilopascal = one kilonewton per meter squared)
A 160lb climber taking a 20 footer onto a dynamic rope generates about 4KN. There are calculators for getting this accurate - I just know that one off the top of my head.
I don't know the area of the placenta, you'll need that, and you can probably do some basic math from there to get some sort of number.
There might be other biological factors too, like the transfer of that force from the tie in point to the placenta - I don't know about those.
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kriso9tails
Jul 27, 2009, 6:02 PM
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I have no real intention of answering this (too out of touch with the necessary skills), but I am curious to see where it goes. That said, do you mean from the effects of a harness in a fall, or if the expectant mother collided with the rock itself in a fall?
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limeydave
Jul 27, 2009, 6:07 PM
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this is interesting -
for a 1m sq placenta (huge and unrealistic) the climber would have to be 400lb and take a 100 footer onto 101feet of rope to get 15KN.
Someone who knows something about anything should chime in now - I'm getting too close to a dangerous and misinformed answer.
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clee03m
Jul 27, 2009, 6:14 PM
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If you mean ledging out or decking, I would think that would be really no different than MVA where even without apparant maternal injury, risk of adverse effects on pregnancy was increased. If you mean a bad belayer slamming you into the wall, a belayer who does not know the concept of a dynamic belay should not belay anyone, preggo or not.
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nate2006
Jul 27, 2009, 6:21 PM
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The average placentas diameter is 22cm. The area of the placenta would be 379.94cm squared.
Converted to meters .037994m squared.
Now take the kPa from the study, 18.6kPa without the chorionic plate. (The plate changes to fiburous tissue during the late stages of gestation).
18.6kPa X .037994 = .7066884 kn
A normal placenta should have the chorionic plate on the fetal side until late term. Which then it becomes more fiborous. The main artery and vein for the baby runs through the chorionic plate.
As for a normal placenta in a women the rupture point is 167.8kPa.
167.8kPa X .037994 = 6.3753932kn
So Around 6 kn, expect to get hurt. You could even get hurt and lose the baby at a mere .7kn. When the placenta or the chorionic plate ruptures the baby and mother can die because they will both bleed to death. Also remember that the placenta itself can rupture at less than 1kn without its protective chorionic plate. The placenta by itself is very fragile.
I recommend not climbing pregnant at all. My wife is 8 months pregnant. Back when she was much earlier in term I would not even let her belay me.
(This post was edited by nate2006 on Jul 27, 2009, 6:28 PM)
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irregularpanda
Jul 27, 2009, 6:27 PM
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I would like to make a motion to move this thread from "general" into "awesome"!
Seriously though, great idea. Here's what I know about abruptio placenta:
It depends on everything. A woman can have a partial abruption, a complete abruption, or a concealed abruption. Also, the ideal location for any placenta to implant is in the superior posterior reagion of the uterus.
The reason for this is that the uterus has more muscles there, and post delivery/abruption, those muscles will contract more and thus be able to stop the bleeding more efficiently than if the fetus had implanted elsewhere.
As far as the data and forces involved, I have no idea. When I read that blurb from your article all I could think was that these people did computer modeling on 7 placentas because they could not find a way to test this safely. They also appeared to study the strength of the placenta itself, without actually looking at the strength between the placenta and the endometrium.
Abruptio placenta kills babies, and could kill the mother also due to hypovolemic shock. It's a true medical emergency. Hence not being able to study this in utero.
However, every placenta is different and every uterus is different. The exact cause of abruptio placenta is completely unknown, although there are a number of other risk factors involved. I am sure that it is not always caused by direct trauma to the uterus. This is why I said earlier that it depends. Some women can churn out 30 babies and never have a problem. Other women can develop placental abruptions in every pregnancy and never come to full term. Do we know why this happens? no. But we can determine risk factors.
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irregularpanda
Jul 27, 2009, 6:38 PM
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clee03m wrote: I was doing some research into how much force is enough to cause placental abruption. I was hoping someone could translate some of this into useful numbers for climbing. Should have paid more attention is my physics classes...
Sorry, should have asked this earlier.
What is your background in OB? How much do you know, and how much do you not know?
I assume you're in school. For what?
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ptlong
Jul 27, 2009, 7:01 PM
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nate2006 wrote: The average placentas diameter is 22cm. The area of the placenta would be 379.94cm squared. Converted to meters .037994m squared. Now take the kPa from the study, 18.6kPa without the chorionic plate. (The plate changes to fiburous tissue during the late stages of gestation). 18.6kPa X .037994 = .7066884 kn A normal placenta should have the chorionic plate on the fetal side until late term. Which then it becomes more fiborous. The main artery and vein for the baby runs through the chorionic plate. As for a normal placenta in a women the rupture point is 167.8kPa. 167.8kPa X .037994 = 6.3753932kn So Around 6 kn, expect to get hurt.
6 kN would be the force on the placenta, not the tension in the climbing rope.
What's a placenta weigh, on the order of 1 kg? To get 6 kN you'd need an acceleration in excess of 600 g. If it really requires that much force to rip a placenta you'll never generate it in a climbing fall unless you hit something.
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clee03m
Jul 27, 2009, 7:19 PM
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No not in school. I am an anesthesiologist and my extent of OB experience is in medical school rotation. Just trying to have a baby and seeing how much risk is involved in leading while pregnant. In this litigious environment, I would assume an OB will advise me not to climb at all. So I am doing the research on my own.
I have not found anything that suggest that TR'ing is dangerous.
(This post was edited by clee03m on Jul 27, 2009, 7:40 PM)
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irregularpanda
Jul 27, 2009, 7:49 PM
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Good luck on your mission. It sounds like hard data to acquire. I would say, personally, just go climb and make sure the gear/bolts are close together and you get a dynamic belay.
You could also wear an improvised chest harness to distribute force of impact more evenly.
As far as finding any actual data....meh.
If you look closely at this study, and I'm sure you have the entire study, it sounds to me like 2 things.
1. a proposal for how to study this concept further, If more placenta's are acquired.
2. Useless, because the maternal layer and the chorion layer are separated. How can they measure placental abruption when the placentas they study are separated (maternal vs chorionic) in the first place? In my opinion, it is the strength of the interaction between these two layers that will predispose a mother to abruption (or not).
clee03m wrote: This study presents a total of 20 dynamic uniaxial tensile tests on the maternal side of the placenta and 10 dynamic uniaxial tensile tests on the chorion layer of the placenta.
I would say that a more useful way to look at this information would be to compare the placental abruption between two types of impacts in car accidents.
T-bones and head ons.
A t-bone collision has a MOI that involves more twisting forces. Similar to the way a t-bone causes c-spine fractures and whiplash. The uterus would twist around, with a shearing force. This could possibly cause a placental abruption, as the force of impact is unevenly distributed within the uterus.
A head on collision would have more of an even distribution of force. ( I would think) and therefore less abruptio placenta. While the force of impact is more abrupt and sudden, the distribution of impact could be more even.
Which of these resembles a climbing fall? That's a good question, and in my opinion, more relevant than a study that rips placental layers that are already separated.
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nate2006
Jul 27, 2009, 8:00 PM
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ptlong wrote: 6 kN would be the force on the placenta, not the tension in the climbing rope.
Right, it would be the final force applied to the placenta after all energy absorption had occured.
ptlong wrote: What's a placenta weigh, on the order of 1 kg? To get 6 kN you'd need an acceleration in excess of 600 g. If it really requires that much force to rip a placenta you'll never generate it in a climbing fall unless you hit something.
Yeah but the placenta isn't getting dropped on a rope. Its an entire human body plus gear generating the forces. What we want to know is how much of that force generated by the body falling will rupture a placenta.
The 6kn is not measuring when the placenta ruptures but rather when the layer on the platenta that points toward the baby will rupture.
The placenta by itself will rupture at a much lower force. Only .7 kn in this example.
What we have not measured or have access to is data pertaining to the placenta attached to the uterus and the forces that are required to rupture the placenta from the uterus. I'm not sure where one could get that combination and be able to test it....
You could easily generate the lower forces in a climbing fall (.7kn).
Having the placenta separate from the uterus would be just as bad and we don't even know what kind of forces it would take to do that.
I also agree with irregularpanda that the study is not a good example because the placenta and chorionic plate have been separated.
(This post was edited by nate2006 on Jul 27, 2009, 8:05 PM)
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irregularpanda
Jul 27, 2009, 8:14 PM
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nate2006 wrote: What we have not measured or have access to is data pertaining to the placenta attached to the uterus and the forces that are required to rupture the placenta from the uterus. I'm not sure where one could get that combination and be able to test it....
Exactly.
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kriso9tails
Jul 27, 2009, 9:00 PM
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clee03m wrote: If you mean a bad belayer slamming you into the wall, a belayer who does not know the concept of a dynamic belay should not belay anyone, preggo or not.
I was just thinking of something else when I initially read the question. I don't agree with the above statement in context; however, it's not relevant to the conversation.
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dhorgan
Jul 27, 2009, 9:00 PM
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Hi:
I think irregularpanda's comment pretty well captures it: "it depends on everything". (For context, I'm an FP.)
As you know, women can abrupt with NO trauma, spontaneously. And others can get involved in major car accidents and be fine. I've delivered perfect babies to moms who lived on the street, doing crack, and had problems with moms who were doing everything right.
The difficulty with this whole line of questioning is that a pregnancy is not a mass-produced product that can be 3-sigma tested. Every one is different, even in the same mom, and (in the case of twins) even in the same pregnancy. So I think any question of analyzing shear force from some in vitro study or whatever is going to just confuse the issue, giving you a sense that as long as you don't cross some particular line, you're in good shape. Truly, though, you're in good shape when baby's delivered and nursing. Until then, pregnancy is incredibly unpredictable.
I tell my pregnant patients to avoid doing things where they can suffer an impact or a fall. Any form of rock climbing would come under that heading. How about ramping up the cardio and the strength training (unlikely to fall from pull-up bar, and they'd be weighted pull-ups!) and come back silly strong after baby arrives?
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ptlong
Jul 27, 2009, 9:16 PM
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nate2006 wrote: ptlong wrote: 6 kN would be the force on the placenta, not the tension in the climbing rope. Right, it would be the final force applied to the placenta after all energy absorption had occured. ptlong wrote: What's a placenta weigh, on the order of 1 kg? To get 6 kN you'd need an acceleration in excess of 600 g. If it really requires that much force to rip a placenta you'll never generate it in a climbing fall unless you hit something. Yeah but the placenta isn't getting dropped on a rope. Its an entire human body plus gear generating the forces. What we want to know is how much of that force generated by the body falling will rupture a placenta.
The force on the placenta does not equal the force on the woman's body.
The force they're talking about is the stress in the tissue that is due to the relative displacement of the uterine wall and the rest of the placenta. It's probably fairly complicated. Does the fetus play a role in pulling on the placenta?
nate2006 wrote: You could easily generate the lower forces in a climbing fall (.7kn).
A typical climber feels that much force sitting quietly at the base.
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clee03m
Jul 27, 2009, 9:40 PM
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dhorgan wrote: Hi: I think irregularpanda's comment pretty well captures it: "it depends on everything". (For context, I'm an FP.) As you know, women can abrupt with NO trauma, spontaneously. And others can get involved in major car accidents and be fine. I've delivered perfect babies to moms who lived on the street, doing crack, and had problems with moms who were doing everything right. The difficulty with this whole line of questioning is that a pregnancy is not a mass-produced product that can be 3-sigma tested. Every one is different, even in the same mom, and (in the case of twins) even in the same pregnancy. So I think any question of analyzing shear force from some in vitro study or whatever is going to just confuse the issue, giving you a sense that as long as you don't cross some particular line, you're in good shape. Truly, though, you're in good shape when baby's delivered and nursing. Until then, pregnancy is incredibly unpredictable. I tell my pregnant patients to avoid doing things where they can suffer an impact or a fall. Any form of rock climbing would come under that heading. How about ramping up the cardio and the strength training (unlikely to fall from pull-up bar, and they'd be weighted pull-ups!) and come back silly strong after baby arrives?
I couldn't disagree with your logic (or should I say illogic) more. None of medicine is clear cut. But we still practice evidence based medicine. Clearly, I am not going solely on this info, just rusty on my physics and needed a little help. I will decide to lead or not based on science and not because of your recommendation that everyone is different so stop climbing altogether. Your suggestion is for me to stop TR'ing? For what reason? You must do some bad ass TR. I would like to see you stop climbing for 9 months and do only cardio and pull ups and come back stronger, even without putting pregnancy into the equation.
Thanks for the helpful replies. And to the rest of you, peoples, I do not want your non-science voodoo.
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nate2006
Jul 27, 2009, 10:46 PM
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ptlong wrote: The force on the placenta does not equal the force on the woman's body.
I see where you are coming from. Its hard to say how much force is actually applied to our innards after a decent fall. Especially when we are pinpointing one organ in the body.
ptlong wrote: Does the fetus play a role in pulling on the placenta?
I imagine the fetus does pull on the placenta at times depending on many factors.
ptlong wrote: A typical climber feels that much force sitting quietly at the base.
Of course everyone is feeling that much force just being on this planet. However that is potential energy. Its when it converts from potential to kinetic back to potential that the body can be injured.
One can argue about the forces that are applied to the body and why you should or should not climb forever. I think the bottom line in this case is that every pregnancy is different with many variables, adding more variables into that equation can prove harmful.
Climb at your own risk.
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onceahardman
Jul 27, 2009, 11:11 PM
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clee03m wrote: dhorgan wrote: Hi: I think irregularpanda's comment pretty well captures it: "it depends on everything". (For context, I'm an FP.) As you know, women can abrupt with NO trauma, spontaneously. And others can get involved in major car accidents and be fine. I've delivered perfect babies to moms who lived on the street, doing crack, and had problems with moms who were doing everything right. The difficulty with this whole line of questioning is that a pregnancy is not a mass-produced product that can be 3-sigma tested. Every one is different, even in the same mom, and (in the case of twins) even in the same pregnancy. So I think any question of analyzing shear force from some in vitro study or whatever is going to just confuse the issue, giving you a sense that as long as you don't cross some particular line, you're in good shape. Truly, though, you're in good shape when baby's delivered and nursing. Until then, pregnancy is incredibly unpredictable. I tell my pregnant patients to avoid doing things where they can suffer an impact or a fall. Any form of rock climbing would come under that heading. How about ramping up the cardio and the strength training (unlikely to fall from pull-up bar, and they'd be weighted pull-ups!) and come back silly strong after baby arrives? I couldn't disagree with your logic (or should I say illogic) more. None of medicine is clear cut. But we still practice evidence based medicine. Clearly, I am not going solely on this info, just rusty on my physics and needed a little help. I will decide to lead or not based on science and not because of your recommendation that everyone is different so stop climbing altogether. Your suggestion is for me to stop TR'ing? For what reason? You must do some bad ass TR. I would like to see you stop climbing for 9 months and do only cardio and pull ups and come back stronger, even without putting pregnancy into the equation. Thanks for the helpful replies. And to the rest of you, peoples, I do not want your non-science voodoo.
I think your answer is horrible.
You can do "back of the envelope" calculations to your heart's content. Maybe that's all you want. But you cannot know whether the theoretical forces you are applying will or will not tear any given placenta, without doing at least several hundred drop tests, with intra-placental force dynomometers, to know:
1) how much force does it take to tear an average placenta? (assuming the phrase "average placenta" is statistically meaningful)
2) whether the same distance fall to two different climbers will result in similar injury.
What is not known is unknown. Saying so doesn't make it "voodoo".
Where evidence does not exist, you really can't have evidence-based practice.
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technogeekery
Jul 27, 2009, 11:25 PM
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clee03m - looks like the best "scientific" data is very unlikely to be able to be extrapolated to your own specific case? Sure its interesting and important to do your own research and incorporate that into your decision-making process. But given the imprecision of the scientific approach in this case, your own gut feel and the experience of thousands of women who have been in similar situations (various types of athletes who are/were pregnant) might be as useful.
Good luck whatever you decide :-)
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ptlong
Jul 27, 2009, 11:31 PM
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nate2006 wrote: ptlong wrote: The force on the placenta does not equal the force on the woman's body. I see where you are coming from. Its hard to say how much force is actually applied to our innards after a decent fall. Especially when we are pinpointing one organ in the body.
That's right. You can attempt to model it but it isn't a straightforward exercise.
nate2006 wrote: ptlong wrote: A typical climber feels that much force sitting quietly at the base. Of course everyone is feeling that much force just being on this planet. However that is potential energy. Its when it converts from potential to kinetic back to potential that the body can be injured.
Sorry, but that's not true. Force is force, whether gravitational or non-inertial. Google "equivalence principle".
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ski.ninja
Jul 28, 2009, 12:20 AM
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Does the fact that the waist loop of the harness rests very close to the placenta affect this at all? Wouldn't the webbing cut into the body sharply in the event of a fall? Just curious.
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nate2006
Jul 28, 2009, 12:31 AM
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ski.ninja wrote: Does the fact that the waist loop of the harness rests very close to the placenta affect this at all? Wouldn't the webbing cut into the body sharply in the event of a fall? Just curious.
The waist loop displacement on the abdomen and back would definitely put pressure on your guts. How much pressure put on the placenta would be determined by the womens body. The placenta can actually attach to the wall of the uterus in different spots with each pregnancy.
The belt would cut into your soft tissue a bit. However it is the acceleration and sudden deceleration of a fall that is going to slam your guts to the bottom of your abdomen.
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irregularpanda
Jul 28, 2009, 12:42 AM
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dhorgan wrote: Hi: I think irregularpanda's comment pretty well captures it: "it depends on everything". (For context, I'm an FP.) As you know, women can abrupt with NO trauma, spontaneously. And others can get involved in major car accidents and be fine. I've delivered perfect babies to moms who lived on the street, doing crack, and had problems with moms who were doing everything right. The difficulty with this whole line of questioning is that a pregnancy is not a mass-produced product that can be 3-sigma tested. Every one is different, even in the same mom, and (in the case of twins) even in the same pregnancy. So I think any question of analyzing shear force from some in vitro study or whatever is going to just confuse the issue, giving you a sense that as long as you don't cross some particular line, you're in good shape. Truly, though, you're in good shape when baby's delivered and nursing. Until then, pregnancy is incredibly unpredictable. I tell my pregnant patients to avoid doing things where they can suffer an impact or a fall. Any form of rock climbing would come under that heading. How about ramping up the cardio and the strength training (unlikely to fall from pull-up bar, and they'd be weighted pull-ups!) and come back silly strong after baby arrives?
Can I just point out the obvious here:
This is the only person on this series of posts so far who practices Obstetrics.
I have studied obstetrics. However, I will never Practice obstetrics actively.
Do what you want though. I'd say climb things you know you won't fall on. That's it. Dhorgan is right.....anything can happen during a pregnancy. A woman can have abruptio placenta while they are waiting for the bus. Another woman could use every illicit drug known to mankind and not have this *medical emergency* happen. Nobody knows why it happens, although I'd be willing to bet that certain people (hint hint) could explain the risk factors better than myself.
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