Skip to main content
SpringerLink
Log in

Evaluation of Strains on Levator Ani Muscle: Damage Induced During Delivery for a Prediction of Patient Risks

  • Conference paper
  • First Online:
Computational Biomechanics for Medicine

Abstract

Since childbirth presents a significant risk factor for pathology occurrence of the pelvic floor, analysis of the phenomena involved during a vaginal delivery is a major issue in obstetrics and gynecology researches. Computational biomechanics tool dedicated to the delivery could help to understand the causes of injuries and predict the perineal lesion. From MRI images of four women at different terms of pregnancy, a parametric FE model is generated and allows to analyze the potential damage areas during childbirth, related to strain rate of anatomical structures. The influence of the geometry of levator ani muscle, head size, terms, and cephalic presentations are investigated. The geometrical refinement of anatomical structures influences the strain levels and helps to localized more precisely the most injured areas. Posterior cephalic presentation presents higher injury risk than the anterior one. Maternal geometry at different terms brings equivalent results contrary to the fetal head sizes that have an influence on the strain level and the potential damage induced. This multi-parametric investigation allows us to have a customizable and predictive tool evaluating the potential damages on the pelvis during delivery.

This is a preview of subscription content, log in via an institution to check access.

Access this chapter

Log in via an institution
Chapter
USD 29.95
Price excludes VAT (USA)
  • Available as PDF
  • Read on any device
  • Instant download
  • Own it forever
eBook
USD 169.00
Price excludes VAT (USA)
  • Available as EPUB and PDF
  • Read on any device
  • Instant download
  • Own it forever
Softcover Book
USD 219.99
Price excludes VAT (USA)
  • Compact, lightweight edition
  • Dispatched in 3 to 5 business days
  • Free shipping worldwide - see info
Hardcover Book
USD 219.99
Price excludes VAT (USA)
  • Durable hardcover edition
  • Dispatched in 3 to 5 business days
  • Free shipping worldwide - see info

Tax calculation will be finalised at checkout

Purchases are for personal use only

Institutional subscriptions

References

  1. Mayeur O, Witz JF, Lecomte-Grosbras P, Brieu M, Cosson M, Miller K (2016) Influence of geometry and mechanical properties on the accuracy of patient-specific simulation of women pelvic floor. Ann Biomed Eng 44(1):202–212

    Article  Google Scholar 

  2. Samuelsson EC, Arne Victor FT, Tibblin G, Svardsudd KF (1999) Signs of genital prolapse in a Swedish population of women 20 to 59 years of age and possible related factors. Am J Obstet Gynecol 180(2):299–305

    Article  Google Scholar 

  3. Rortveit G, Brown JS, Thom DH, Van Den Eeden SK, Creasman JM, Subak LL (2007) Symptomatic pelvic organ prolapse: prevalence and risk factors in a population-based, racially diverse cohort. Obstet Gynecol 109(6):1396–1403

    Article  Google Scholar 

  4. O’Boyle AL, O’Boyle JD, Ricks RE, Patience TH, Calhoun B, Davis G (2003) The natural history of pelvic organ support in pregnancy. Int Urogynecol J Pelvic Floor Dysfunct 14(1): 46–49

    Article  Google Scholar 

  5. Rahn DD, Ruff MD, Brown SA, Tibbals HF, Word RA (2008) Biomechanical properties of the vaginal wall: effect of pregnancy, elastic fiber deficiency, and pelvic organ prolapse. Am J Obstet Gynecol 198(5):590–596

    Article  Google Scholar 

  6. Sultan AH (1999) Clinical focus: obstetric perineal injury and faecal incontinence after childbirth – editorial: obstetrical perineal injury and anal incontinence. Clin Risk 5(6): 193–196

    Google Scholar 

  7. Kettle C, Tohill S (2008) Perineal care. BMJ Clin Evidence 2008:1–18

    Google Scholar 

  8. Dietz HP, Lanzarone V (2005) Levator trauma after vaginal delivery. Obstet Gynecol 106(4):707–712

    Article  Google Scholar 

  9. Dietz HP, Gillespie AV, Phadke P (2007) Avulsion of the pubovisceral muscle associated with large vaginal tear after normal vaginal delivery at term. ANZJOG 47(4):341–344

    Google Scholar 

  10. DeLancey JOL, Kearney R, Chou Q, Speights S, Binno S (2003) The appearance of levator ani muscle abnormalities in magnetic resonance images after vaginal delivery. Obstet Gynecol 101(1):46–53

    Google Scholar 

  11. Chen L, Ashton-Miller JA, DeLancey JOL (2009) A 3d finite element model of anterior vaginal wall support to evaluate mechanisms underlying cystocele formation. J Biomech 42(10): 1371–1377

    Article  Google Scholar 

  12. Parente MPL, Natal Jorge RM, Mascarenhas T, Fernandes AA, Martins JAC (2009) The influence of the material properties on the biomechanical behavior of the pelvic floor muscles during vaginal delivery. J Biomech 42(9):1301–1306

    Article  Google Scholar 

  13. Ashton-Miller JA, Delancey JOL (2009) On the biomechanics of vaginal birth and common sequelae. Annu Rev Biomed Eng 11:163–176

    Article  Google Scholar 

  14. van Delft K, Thakar R, Sultan AH, Schwertner-Tiepelmann N, Kluivers K (2014) Levator ani muscle avulsion during childbirth: a risk prediction model. BJOG 121(9):1155–1163

    Article  Google Scholar 

  15. Li X, Kruger JA, Nash MP, Nielsen PMF (2010) Anisotropic effects of the levator ani muscle during childbirth. Biomech Model Mechanobiol 10(4):485–494

    Article  Google Scholar 

  16. Li X, Kruger JA, Nash MP, Nielsen PMF (2010) Effects of nonlinear muscle elasticity on pelvic floor mechanics during vaginal childbirth. J Biomech Eng 132(11):111010–111015

    Article  Google Scholar 

  17. Rubod C, Boukerrou M, Brieu M, Jean-Charles C, Dubois P, Cosson M (2008) Biomechanical properties of vaginal tissue: preliminary results. Int Urogynecol J Pelvic Floor Dysfunct 121(9):811–816

    Article  Google Scholar 

  18. Chantereau P, Brieu M, Kammal M, Farthmann J, Gabriel B, Cosson M (2014) Mechanical properties of pelvic soft tissue of young women and impact of aging. Int Urogynecol J 25(11):1547–1553

    Article  Google Scholar 

  19. Yeoh OH (1993) Some forms of the strain energy function for rubber. Rubber Chem Technol 66(5):754–771

    Article  Google Scholar 

  20. Rubod C, Brieu M, Cosson M, Rivaux G, Clay JC, Gabriel B (2012) Biomechanical properties of human pelvic organs. J Urol 79(4):1346–1354

    Google Scholar 

  21. Salameh C, Canoui-Poitrine F, Cortet M, Lafon A, Rudigoz RC, Huissoud C (2011) Does persistent occiput posterior position increase the risk of severe perineal laceration? Gynecol Obstet Fertil 39(10):545–548

    Article  Google Scholar 

  22. Pergialiotis V, Vlachos D, Protopapas A, Pappa K, Vlachos G (2014) Risk factors for severe perineal lacerations during childbirth. Int J Gynaecol Obstet 125(1):6–14

    Article  Google Scholar 

  23. Ponkey SE, Cohen AP, Heffner LJ, Lieberman E (2003) Persistent fetal occiput posterior position: obstetric outcomes. Obstet Gynecol 101(5):915–920

    Google Scholar 

  24. Berardi M, Martinez-Romero O, Elías-Zúñiga A, Rodríguez M, Ceretti E, Fiorentino A, Donzella G, Avanzini A (2014) Levator ani deformation during the second stage of labour. Proc Inst Mech Eng 228:501–508

    Article  Google Scholar 

  25. Dejun J, Ashton-Miller JA, DeLancey JOL (2012) A subject specific anisotropic visco-hyperelastic finite element model of female pelvic floor stress and strain during the second stage of labor. J Biomech 45(3):455–460

    Article  Google Scholar 

Download references

Acknowledgments

This research is a part of the project « MAMAN » financially supported by the University of Lille 2.

Author information

Authors and Affiliations

  1. Centrale Lille, Villeneuve-d’Ascq, France

    Olivier Mayeur, Jean-François Witz, Pauline Lecomte-Grosbras & Mathias Brieu

  2. Laboratoire de Mécanique de Lille, CNRS FRE-3723, Villeneuve-d’Ascq, France

    Olivier Mayeur, Estelle Jeanditgautier, Jean-François Witz, Pauline Lecomte-Grosbras, Michel Cosson, Chrystele Rubod & Mathias Brieu

  3. CHU Lille, Service de Chirurgie Gynécologique, 59000, Lille, France

    Estelle Jeanditgautier, Michel Cosson & Chrystele Rubod

  4. Université Lille Nord de France, Faculté de Médecine, 59000, Lille, France

    Estelle Jeanditgautier, Michel Cosson & Chrystele Rubod

Authors
  1. Olivier Mayeur
    View author publications

    You can also search for this author in PubMed Google Scholar

  2. Estelle Jeanditgautier
    View author publications

    You can also search for this author in PubMed Google Scholar

  3. Jean-François Witz
    View author publications

    You can also search for this author in PubMed Google Scholar

  4. Pauline Lecomte-Grosbras
    View author publications

    You can also search for this author in PubMed Google Scholar

  5. Michel Cosson
    View author publications

    You can also search for this author in PubMed Google Scholar

  6. Chrystele Rubod
    View author publications

    You can also search for this author in PubMed Google Scholar

  7. Mathias Brieu
    View author publications

    You can also search for this author in PubMed Google Scholar

Corresponding author

Correspondence to Olivier Mayeur .

Editor information

Editors and Affiliations

  1. Intelligent Systems for Medicine Laboratory, School of Mechanical and Chemical Engineering, The University of Western Australia, Perth, West Australia, Australia

    Adam Wittek

  2. Intelligent Systems for Medicine Laboratory, School of Mechanical and Chemical Engineering, The University of Western Australia, Perth, West Australia, Australia

    Grand Joldes

  3. Auckland Bioengineering Institute, The University of Auckland, Auckland, New Zealand

    Poul M.F. Nielsen

  4. School of Mechanical and Chemical Engineering, The University of Western Australia, Perth, West Australia, Australia

    Barry J. Doyle

  5. Intelligent Systems for Medicine Laboratory, School of Mechanical and Chemical Engineering, The University of Western Australia, Perth, West Australia, Australia

    Karol Miller

Rights and permissions

Reprints and permissions

Copyright information

© 2017 Springer International Publishing AG

About this paper

Cite this paper

Mayeur, O. et al. (2017). Evaluation of Strains on Levator Ani Muscle: Damage Induced During Delivery for a Prediction of Patient Risks. In: Wittek, A., Joldes, G., Nielsen, P., Doyle, B., Miller, K. (eds) Computational Biomechanics for Medicine. Springer, Cham. https://doi.org/10.1007/978-3-319-54481-6_12

Download citation

  • DOI: https://doi.org/10.1007/978-3-319-54481-6_12

  • Published:

  • Publisher Name: Springer, Cham

  • Print ISBN: 978-3-319-54480-9

  • Online ISBN: 978-3-319-54481-6

  • eBook Packages: EngineeringEngineering (R0)

Publish with us

Policies and ethics

Search

Navigation