دورية أكاديمية
أعرض في EDS

On the variation in maternal birth canal in vivo viscoelastic properties and their effect on the predicted length of active second stage and levator ani tears.

التفاصيل البيبلوغرافية
العنوان: On the variation in maternal birth canal in vivo viscoelastic properties and their effect on the predicted length of active second stage and levator ani tears.
المؤلفون: Tracy PV; Department of Biomedical Engineering, University of Michigan, 2350 Hayward Street, Ann Arbor, MI 48109-2110, United States. Electronic address: voigtpai@umich.edu., Wadhwani S; Department of Biomedical Engineering, University of Michigan, 2350 Hayward Street, Ann Arbor, MI 48109-2110, United States. Electronic address: shreyaw@umich.edu., Triebwasser J; Department of Obstetrics and Gynecology, University of Michigan, L4000 University Hospital South, 1500 E. Medical Center Dr., Ann Arbor, MI 48109-5276, United States. Electronic address: jtriebwa@med.umich.edu., Wineman AS; Department of Mechanical Engineering, University of Michigan, 2350 Hayward Street, Ann Arbor, MI 48109-2120, United States. Electronic address: lardan@umich.edu., Orejuela FJ; Department of Obstetrics and Gynecology, Baylor College of Medicine, 6651 Main Street, Suite F320, Houston, TX 77030, United States. Electronic address: Francisco.Orejuela@bcm.edu., Ramin SM; Department of Obstetrics and Gynecology, Baylor College of Medicine, 6651 Main Street, Suite F320, Houston, TX 77030, United States. Electronic address: smramin@bcm.edu., DeLancey JO; Department of Obstetrics and Gynecology, University of Michigan, L4000 University Hospital South, 1500 E. Medical Center Dr., Ann Arbor, MI 48109-5276, United States. Electronic address: delancey@med.umich.edu., Ashton-Miller JA; Department of Biomedical Engineering, University of Michigan, 2350 Hayward Street, Ann Arbor, MI 48109-2110, United States; Department of Mechanical Engineering, University of Michigan, 2350 Hayward Street, Ann Arbor, MI 48109-2120, United States. Electronic address: jaam@umich.edu.
المصدر: Journal of biomechanics [J Biomech] 2018 Jun 06; Vol. 74, pp. 64-71. Date of Electronic Publication: 2018 Apr 25.
نوع المنشور: Journal Article; Research Support, N.I.H., Extramural
اللغة: English
بيانات الدورية: Publisher: Elsevier Science Country of Publication: United States NLM ID: 0157375 Publication Model: Print-Electronic Cited Medium: Internet ISSN: 1873-2380 (Electronic) Linking ISSN: 00219290 NLM ISO Abbreviation: J Biomech Subsets: MEDLINE
أسماء مطبوعة: Original Publication: New York ; Oxford : Elsevier Science
مواضيع طبية MeSH: Elasticity* , Mothers* , Parturition*, Rupture/*pathology , Vagina/*pathology, Female ; Humans ; Pregnancy ; Viscosity
مستخلص: The pubovisceral muscles (PVM) help form the distal maternal birth canal. It is not known why 13% of vaginal deliveries end in PVM tears, so insights are needed to better prevent them because their sequelae can lead to pelvic organ prolapse later in life. In this paper we provide the first quantification of the variation in in vivo viscoelastic properties of the intact distal birth canal in healthy nulliparous women using Fung's Quasilinear Viscoelastic Theory and a secondary analysis of data from a clinical trial of constant force birth canal dilation to 8 cm diameter in the first stage of labor in 26 nullipara. We hypothesized that no significant inter-individual variation would be found in the long time constant, τ 2, which characterizes how long it takes the birth canal to be dilated by the fetal head. That hypothesis was rejected because τ 2 values ranged 20-fold above and below the median value. These data were input to a biomechanical model to calculate how such variations affect the predicted length of the active second stage of labor as well as PVM tear risk. The results show there was a 100-fold change in the predicted length of active second stage for the shortest and longest τ 2 values, with a noticeable increase for τ 2 values over 1000 s. The correlation coefficent between predicted and observed second stage durations was 0.51. We conclude that τ 2 is a strong theoretical contributor to the time a mother has to push in order to deliver a fetal head larger than her birth canal, and a weak predictor of PVM tear risk.
(Copyright © 2018 Elsevier Ltd. All rights reserved.)
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معلومات مُعتمدة: P50 HD044406 United States HD NICHD NIH HHS
فهرسة مساهمة: Keywords: Birth; Injury; Levator ani; Second stage duration; Viscoelasticity
تواريخ الأحداث: Date Created: 20180508 Date Completed: 20190404 Latest Revision: 20210109
رمز التحديث: 20240628
مُعرف محوري في PubMed: PMC5962441
DOI: 10.1016/j.jbiomech.2018.04.019
PMID: 29731323
قاعدة البيانات: MEDLINE
الوصف
تدمد:1873-2380
DOI:10.1016/j.jbiomech.2018.04.019