Numerical simulation of the damage evolution in the pelvic floor muscles during childbirth

被引:38
作者
Oliveira, Dulce A. [1 ]
Parente, Marco P. L. [1 ]
Calvo, Begona [2 ,3 ]
Mascarenhas, Teresa [4 ]
Natal Jorge, Renato M. [1 ]
机构
[1] Univ Porto, INEGI, LAETA, Fac Engn, Rua Dr Roberto Frias S-N, P-4200465 Oporto, Portugal
[2] Univ Zaragoza, Aragon Inst Engn Res, Calle Maria de Luna 3, Zaragoza 50018, Spain
[3] Biomed Res Networking Ctr Bioengn Biomat & Nanome, Madrid, Spain
[4] Univ Porto, Dept Gynecol & Obstet, Ctr Hosp Sao Joao EPE, Fac Med, Alameda Prof Hernani Monteiro, P-4200319 Oporto, Portugal
关键词
Pelvic floor disorders; Constitutive model; Damage mechanics; Finite element method; LEVATOR ANI MUSCLE; BIOMECHANICAL BEHAVIOR; URINARY-INCONTINENCE; RISK-FACTORS; FORMULATION; PROLAPSE; MODEL;
D O I
10.1016/j.jbiomech.2016.01.014
中图分类号
Q6 [生物物理学];
学科分类号
071011 ;
摘要
Several studies have shown that pelvic floor injuries during a vaginal delivery can be considered a significant factor in the development of pelvic floor dysfunction. Such disorders include a group of conditions affecting women like urinary incontinence, pelvic organ prolapse and fecal incontinence. Numerical simulations are valuable tools that are contributing to the clarification of the mechanisms behind pelvic floor disorders. The aim of this work is to propose a mechanical model implemented in the finite element method context to estimate the damage in the pelvic floor muscles by mechanical effects during a vaginal delivery of a fetus in vertex presentation and occipitoanterior position. The constitutive model adopted has already been successfully used in the simulation of childbirth and the structural damage model added has previously been applied to characterize the damage process in biological soft tissues undergoing finite deformations. The constitutive parameters were fit to experimental data available in the literature and the final proposed material model is suitable to estimate the mechanical damage in the pelvic floor muscle during a vaginal delivery. The computational model predicts that even an apparently uneventful vaginal delivery inflicts injuries to the pelvic floor muscles, particularly during the extension of the fetus head, having been obtained more than 10% of damaged fibers. As a clinical evidence, the present work allows to conclude that the puborectalis component of the levator ani muscle is the most prone to damage. (C) 2016 Elsevier Ltd. All rights reserved.
引用
收藏
页码:594 / 601
页数:8
相关论文
共 31 条
  • [1] Functional anatomy of the female pelvic floor
    Ashton-Miller, James A.
    Delancey, John O. L.
    [J]. REPRODUCTIVE BIOMECHANICS, 2007, 1101 : 266 - 296
  • [2] Baratz M., 1999, Orthopaedic surgery: The Essentials
  • [3] Nonlocal integral formulations of plasticity and damage:: Survey of progress
    Bazant, ZP
    Jirásek, M
    [J]. JOURNAL OF ENGINEERING MECHANICS, 2002, 128 (11) : 1119 - 1149
  • [4] Biomechanical simulation of the fetal descent without imposed theoretical trajectory
    Buttin, Romain
    Zara, Florence
    Shariat, Behzad
    Redarce, Tanneguy
    Grange, Gilles
    [J]. COMPUTER METHODS AND PROGRAMS IN BIOMEDICINE, 2013, 111 (02) : 389 - 401
  • [5] An uncoupled directional damage model for fibred biological soft tissues.: Formulation and computational aspects
    Calvo, B.
    Pena, E.
    Martinez, M. A.
    Doblare, M.
    [J]. INTERNATIONAL JOURNAL FOR NUMERICAL METHODS IN ENGINEERING, 2007, 69 (10) : 2036 - 2057
  • [6] Orientation and length of mammalian skeletal myocytes in response to a unidirectional stretch
    Collinsworth, AM
    Torgan, CE
    Nagda, SN
    Rajalingam, RJ
    Kraus, WE
    Truskey, GA
    [J]. CELL AND TISSUE RESEARCH, 2000, 302 (02) : 243 - 251
  • [7] Biological variability in biomechanical engineering research: Significance and meta-analysis of current modeling practices
    Cook, Douglas
    Julias, Margaret
    Nauman, Eric
    [J]. JOURNAL OF BIOMECHANICS, 2014, 47 (06) : 1241 - 1250
  • [8] D'Aulignac D., 2005, Computer Methods in Biomechanics and Biomedical Engineering, V8, P339, DOI 10.1080/10255840500405378
  • [9] Levator trauma after vaginal delivery
    Dietz, HP
    Lanzarone, F
    [J]. OBSTETRICS AND GYNECOLOGY, 2005, 106 (04) : 707 - 712
  • [10] Delivery mode is a major environmental determinant of stress urinary incontinence: Results of the Evanston-Northwestern Twin Sisters Study
    Goldberg, RP
    Abramov, Y
    Botros, S
    Miller, JJ
    Gandhi, S
    Nickolov, A
    Sherman, W
    Sand, PK
    [J]. AMERICAN JOURNAL OF OBSTETRICS AND GYNECOLOGY, 2005, 193 (06) : 2149 - 2153