Tissue biomechanical behavior should be considered in the risk assessment of perineal trauma at childbirth
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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.
KeywordsObstetric anal sphincter injury Shear wave elastography Childbirth Ligamentous laxity Perineal trauma Individualized strategy
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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Conflict of interest
The authors have no conflict of interest to disclose.
This article does not contain any studies with human participants performed by any of the authors.
This article does not contain any studies with human participants performed by any of the authors. This considered details about informed consent are not applicable to this submission.
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