Biomechanical Simulation of Vaginal Childbirth: The Colors of the Pelvic Floor Muscles
Childbirth-related trauma is a recurrent and widespread topic due to the disorders it can trigger, such as urinary and/or anal incontinence, and pelvic organ prolapse, affecting women at various levels. Pelvic floor dysfunction often results from weakening or direct damage to the pelvic floor muscles (PFM) or connective tissue, and vaginal delivery is considered the primary risk factor. Elucidating the normal labor mechanisms and the impact of vaginal delivery in PFM can lead to the development of preventive and therapeutic strategies to minimize the most common injuries. By providing some understanding of the function of the pelvic floor during childbirth, the existing biomechanical models attempt to respond to this problem. These models have been used to estimate the mechanical changes on PFM during delivery, to analyze fetal descent, the effect of the fetal head molding, and delivery techniques that potentially contribute to facilitating labor and reducing the risk of muscle injury.
Biomechanical models of childbirth should be sufficiently well-informed and functional for personalized planning of birth and obstetric interventions. Some challenges to be addressed with a focus on customization will be discussed including the in vivo acquisition of individual-specific pelvic floor mechanical properties.
KeywordsComputational biomechanics Physics-based computational model Vaginal delivery Pelvic floor muscles
The authors gratefully acknowledge the support from the Portuguese Foundation of Science under grants IF/00159/2014, and the funding of project 030062 SIM4SafeBirth—A biomechanical approach to improve childbirth outcomes and NORTE-01-0145-FEDER-000022 SciTech—Science and Technology for Competitive and Sustainable Industries, cofinanced by Norte’s Regional Operational Programme (NORTE2020), through European Regional Development Fund (ERDF).
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