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Tissue biomechanical behavior should be considered in the risk assessment of perineal trauma at childbirth

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Abstract

Perineal trauma at childbirth is associated with strong negative impacts on a woman’s health but remains unpredictable. Pregnancy induces several changes in biomechanical behavior in humans as in animals, namely, an increase in ligamentous laxity and an increase in vaginal distensibility. Pelvic floor muscles in rats are reported to exhibit specific behaviors during pregnancy. Increases in both stiffness and the number of sarcomeres in series are observed and might process that protect against perineal trauma at childbirth. Some data in humans have shown that the risk of perineal trauma is highly linked to the intrinsic characteristics of the tissue, suggesting the potential benefit of incorporating intrinsic biomechanical characteristics in the risk prediction for perineal trauma. Shear wave elastography might be a useful noninvasive tool to investigate the elastic properties of these tissues in pregnant women in vivo, with the goal of implementing these properties as a predictive strategy.

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Funding

There was no funding for this study.

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Authors and Affiliations

  1. Department of Obstetrics and Gynecology, Poitiers University Hospital, Poitiers University, Poitiers, France

    Bertrand Gachon, Fabrice Pierre & Xavier Fritel

  2. Movement - Interactions – Performance, MIP, EA 4334, Nantes Université, 44000, Nantes, France

    Bertrand Gachon & Antoine Nordez

  3. Health and Rehabilitation Research Institute, Faculty of Health and Environmental Sciences, Auckland University of Technology, Auckland, New Zealand

    Antoine Nordez

  4. INSERM, Center for Research in Epidemiology and Population Health (CESP), U1018, Gender, Sexuality and Health Team, University Paris-Sud, UMRS 1018, Orsay, France

    Xavier Fritel

  5. INSERM, Poitiers University Hospital, CIC 1402, Poitiers University, Poitiers, France

    Bertrand Gachon & Xavier Fritel

Authors
  1. Bertrand Gachon
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  2. Antoine Nordez
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  3. Fabrice Pierre
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  4. Xavier Fritel
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Contributions

BG: main text writing, data analysis for the initial and the revised manuscript. AN: review of each version of the manuscript, data analysis for the initial and the revised manuscript. FP: review of each version of the manuscript for the initial and the revised manuscript. XF: review of each version of the manuscript, data analysis, draft the work for the initial and the revised manuscript.

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Correspondence to Bertrand Gachon.

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This article does not contain any studies with human participants performed by any of the authors.

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Gachon, B., Nordez, A., Pierre, F. et al. Tissue biomechanical behavior should be considered in the risk assessment of perineal trauma at childbirth. Arch Gynecol Obstet 300, 1821–1826 (2019). https://doi.org/10.1007/s00404-019-05369-5

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  • DOI: https://doi.org/10.1007/s00404-019-05369-5

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