Mechanisms of Pelvic Floor Trauma During Vaginal Delivery

Ashton‐Miller, James A.; DeLancey, John O.L.

doi:10.1007/978-3-030-40862-6_12

Cited by 8 publications

(16 citation statements)

References 25 publications

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“…From the 101 records included, 23 PFM dynamometers from 15 research groups were identified. PFM dynamometers were grouped into two categories: clinical PFM dynamometers ( n = 20, from 12 research groups), 7–26 meant for research settings, and personal PFM dynamometers ( n = 3, from three groups), which were commercially available and intended for patient use 27–29 …”

Section: Resultsmentioning

confidence: 99%

“…Dynamometers were made of a wide range of materials. Specifically, nine dynamometers were made of aluminum, 7,8,16,19–21,23–25 one was made of plastic externally and steel internally, 17 two were made of stainless‐steel, 9,18 one was made of metal, 26 three out of plastic, 13–15 two out of polylactic acid, 11,12 one was made of acrylonitrile butadiene styrene and polycarbonate 10 and one was of unknown material (not reported) 22 . Of interest, the material used for the research PFM dynamometers appears to have shifted over time from aluminum and stainless‐steel to 3D‐printed plastic (polylactic acid, acrylonitrile butadiene styrene, and polycarbonate), which allows for more possibilities in device design.…”

Section: Resultsmentioning

confidence: 99%

“…There were differences in the structure of the intra‐vaginal dynamometers with one type being more prominent. Fifteen dynamometers were “speculum shaped” 7–13,19–26 and made of two branches, four were cylindrical‐shaped probes, 15–18 and one had four‐leaf spring branches attached to a cylinder 14 . Interestingly, while most speculum‐shaped dynamometers opened their branches in parallel to each other, seven opened in an angle, 9,10,13,23–26 which causes a higher opening pressure applied to deeper vaginal tissues.…”

Section: Resultsmentioning

confidence: 99%

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The state of pelvic floor muscle dynamometry: A scoping review

El-Sayegh

Cacciari

Primeau

et al. 2022

Neurourology and Urodynamics

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To discuss the advantages and limitation of the different pelvic floor muscle (PFM) dynamometers available, both in research and industry, and to present the extent of variation between them in terms of structure, functioning, psychometric properties, and assessment procedures. Methods:We identified relevant studies from four databases (MEDLINE, Compendex, Web of Science, and Derwent Innovations Index) up to December 2020 using terms related to dynamometry and PFM. In addition, we conducted a hand search of the bibliographies of all relevant reports. Peer-reviewed papers, conference proceedings, patents and user's manuals for commercial dynamometers were included and assessed by two independent reviewers. Results: One hundred and one records were included and 23 PFM dynamometers from 15 research groups were identified. From these, 20 were considered as clinical dynamometers (meant for research settings) and three as personal dynamometers (developed by the industry). Overall, significant heterogeneity was found in their structure and functioning, which limits development of normative data for PFM force in women. Further research is needed to assess the psychometric properties of PFM dynamometers and to standardize assessment procedures. Conclusion:This review points up to the heterogeneity of existing dynamometers and methods of assessing PFM function. It highlights the need to better document their design and assessment protocol methods.

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Section: Resultsmentioning

confidence: 99%

Section: Resultsmentioning

confidence: 99%

Section: Resultsmentioning

confidence: 99%

See 1 more Smart Citation

The state of pelvic floor muscle dynamometry: A scoping review

El-Sayegh

Cacciari

Primeau

et al. 2022

Neurourology and Urodynamics

View full text Add to dashboard Cite

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“…Other factors can be obesity, episiotomy, and weight of the baby, smoking, and diabetes [10] . Vaginal delivery may commence damage to the urinary continence mechanism either by direct injury to the muscles of pelvic floor or by damaging their motor innervations during a surgical procedure or by combination of both [11] . Behavioral techniques and lifestyle changes work well for certain types of stress urinary incontinence [12] .…”

Section: Introductionmentioning

confidence: 99%

Effects of Physical therapy Management of Stress Urinary Incontinence among Postnatal Women-A quasi experimental study

Arshad

Waseem

Mahmood³

et al. 2022

JUMDC

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BACKGROUND & OBJECTIVE: During delivery, stress incontinence develops due to weakness of pelvic floor muscles. The objective of the current study was to determine the effects of physiotherapy among post-natal women having stress urinary incontinence. METHODOLOGY: This Quasi-Experimental study was conducted on 40 post-natal women in the age of 25-40 years. The data was collected using a convenient sampling technique. After an informed consent, participants were assessed on the day of the visit, and pelvic floor muscle exercises [kegel exercise] were performed. First, they were assessed on 1st visit and the final assessment was made at end of treatment by using the same physical examination. The assessment was done on 1st visit and after 12 weeks, with 3-5 sessions/week. SPSS version 20.0 was used for analysis of data and paired–t test was used for comparing pre and post intervention. RESULTS: The current study comprised 22 (55%) participants with 25-32 years of age group and 18(45%) in 32-40 years of age. The results showed that 2 (5%) had no urine leakage, while 20(50%) had 3-4 times leakage, 25(62.5%) left their pads /garments during the treatment period. Of them 18(45%) had no restriction and 15(37.5%) had some restriction in daily activities and 19 (47.5%) have fair squeeze, 12 (30%) had a weak squeeze, p-value had shown statistically significant difference at p<0.05, stating that Kegel exercise were found effective than routine interventions for the management of Stress Urinary Incontinence (SUI). CONCLUSION: Kegel exercise (Pelvic floor muscle exercises) appeared to be an effective treatment protocol for postnatal women presenting with stress urinary incontinence with statistically significant differences on pre and post intervention analysis.

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“…According to the investigation [19], it can be found that delivery causes great damage to the maternals' PFM. The biomechanical analysis of the delivery process is helpful to study the mechanism of PFM injury.…”

Section: Introductionmentioning

confidence: 99%

A Simulation Analysis of Maternal Pelvic Floor Muscle

Xuan

Yang

Gao

et al. 2021

IJERPH

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Pelvic floor disorder (PFD) is a common disease affecting the quality of life of middle-aged and elderly women. Pelvic floor muscle (PFM) damage is related to delivery mode, fetal size, and parity. Spontaneous vaginal delivery causes especially great damage to PFM. The purpose of this study was to summarize the characteristics of PFM action during the second stage of labor by collecting female pelvic MRI (magnetic resonance imaging) data and, further, to try to investigate the potential pathogenetic mechanism of PFD. A three-dimensional model was established to study the influence factors and characteristics of PFM strength. In the second stage of labor, the mechanical responses, possible damage, and the key parts of postpartum lesions of PFM due to the different fetal biparietal diameter (BPD) sizes were analyzed by finite element simulations. The research results showed that the peak stress and strain of PFM appeared at one-half of the delivery period and at the attachment point of the pubococcygeus to the skeleton. In addition, during the simulation process, the pubococcygeus was stretched by about 1.2 times and the levator ani muscle was stretched by more than two-fold. There was also greater stress and strain in the middle area of the levator ani muscle and pubococcygeus. According to the statistics, either being too young or in old maternal age will increase the probability of postpartum PFM injury. During delivery, the entire PFM underwent the huge deformation, in which the levator ani muscle and the pubococcygeus were seriously stretched and the attachment point between the pubococcygeus and the skeleton were the places with the highest probability of postpartum lesions.

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Mechanisms of Pelvic Floor Trauma During Vaginal Delivery

Cited by 8 publications

References 25 publications

The state of pelvic floor muscle dynamometry: A scoping review

The state of pelvic floor muscle dynamometry: A scoping review

Effects of Physical therapy Management of Stress Urinary Incontinence among Postnatal Women-A quasi experimental study

A Simulation Analysis of Maternal Pelvic Floor Muscle

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