Abstract
There is preliminary evidence that athletes involved in high-intensity sports for sustained periods have a higher probability of experiencing a prolonged second stage of labour compared to non-athletes. The mechanisms responsible for these differences are not clear, although it is postulated that muscle hypertrophy and increased muscle tone in athletes may contribute to difficulties in vaginal delivery. In order to test these hypotheses, we have constructed individual-specific finite element models of the female pelvic floor (one athlete and one non-athlete) and the fetal head to simulate vaginal delivery and enable quantitative analysis of the differences. The motion of the fetal head descending through the pelvic floor was modelled using finite deformation elasticity with contact mechanics. The force required to push the head was compared between the models and a 45% increase in peak force was observed in the athlete model compared to the non-athlete. In both cases, the overall maximum stretch was induced at the muscle insertions to the pubis. This is the beginning of a quantitative modelling framework that is intended to help clinicians assess the risk of natural versus caesarean birth by taking into account the possible mechanical response of pelvic floor muscles based on their size and activation patterns prior to labour.
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References
Kruger, J., Murphy, B., Thompson, S.: Childbirth and sportswomen: the perceptions of obstetric caregivers. Vision 14(2), 7–15 (2006)
Henderson, C., Macdonald, S.: Mayes’ Midwifery: a Textbook for Midwives, 30th edn. Bailliere Tindall, Edinburgh (2004)
Kruger, J., Heap, S., Murphy, B., Dietz, H.: Pelvic floor function in nulliparous women using three-dimensional ultrasound and magnetic resonance imaging. Obstetrics & Gynecology 111(3), 631–638 (2008)
Li, X., Kruger, J., Chung, J., Nash, M., Nielsen, P.: Modelling the pelvic floor for investigating difficulties during childbirth. In: Proceedings of SPIE 6916(69160V) (2008)
Lapeer, R., Prager, R.: Fetal head moulding: finite element analysis of a fetal skull subjected to uterine pressures during the first stage of labour. Journal of Biomechanics 34, 1125–1133 (2001)
Bonet, J., Wood, R.: Nonlinear Continuum Mechanics for Finite Element Analysis. Cambridge University Press, Cambridge (1997)
Wriggers, P.: Computational Contact Mechanics, 2nd edn. Springer, Heidelberg (2006)
Zavarise, G., Wriggers, P., Schrefler, B.: A method for solving contact problems. International Journal for Numerical Methods in Engineering 42(3), 473–498 (1998)
Herzog, W.: Skeletal Muscle Mechanics: From Mechanisms to Function. John Wiley & Sons, Chichester (2000)
Lee, S., Darzi, A., Yang, G.: Subject specific finite element modelling of the levator ani. Medical Image Computing and Computer-Assisted Intervention 8, 360–367 (2005)
Ionescu, I., Guilkey, J., Berzins, M., Kirby, M., Weiss, J.: Computational simulation of penetrating trauma in biological soft tissues using the material point method. Studies in Health Technology and Informatics 111, 213–218 (2005)
Teran, J., Sifakis, E., Blemker, S., Hing, T., Lau, C., Fedkiw, R.: Creating and simulating skeletal muscle from the visible human data set. Institute of Electrical and Electronics Engineers Transactions on Visualization and Computer Graphics 11(3), 317–324 (2005)
Martins, J., Pato, M., Pires, E., Nataljorge, R., Parente, M., Mascarenhas, T.: Finite element studies of the deformation of the pelvic floor. Annals of the New York Academy of Sciences 1101(1), 316–334 (2007)
Hoyte, L., Damaser, M., Warfield, S., Chukkapalli, G., Majumdar, A., Choi, D., Trivedi, A., Krysl, P.: Quantity and distribution of levator ani stretch during simulated vaginal childbirth. Urogynecology (in press, 2008)
Lien, K., Mooney, B., DeLancey, J., Ashton-Miller, J.: Levator ani muscle stretch induced by simulated vaginal birth. The American College of Obstetricians and Gynecologists 103(1), 31–40 (2004)
Kruger, J., Murphy, B., Nielsen, P.: Pelvic floor muscle compliance in elite athletes. In: Abstract ICS Cairo 2008 (accepted, 2008)
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Li, X., Kruger, J.A., Chung, JH., Nash, M.P., Nielsen, P.M.F. (2008). Modelling Childbirth: Comparing Athlete and Non-athlete Pelvic Floor Mechanics. In: Metaxas, D., Axel, L., Fichtinger, G., Székely, G. (eds) Medical Image Computing and Computer-Assisted Intervention – MICCAI 2008. MICCAI 2008. Lecture Notes in Computer Science, vol 5242. Springer, Berlin, Heidelberg. https://doi.org/10.1007/978-3-540-85990-1_90
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DOI: https://doi.org/10.1007/978-3-540-85990-1_90
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