Archives of Gynecology and Obstetrics

, Volume 300, Issue 6, pp 1821–1826 | Cite as

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

  • Bertrand GachonEmail author
  • Antoine Nordez
  • Fabrice Pierre
  • Xavier Fritel
Guidelines and Position Statements


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.


Obstetric anal sphincter injury Shear wave elastography Childbirth Ligamentous laxity Perineal trauma Individualized strategy 


Author 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.


There was no funding for this study.

Compliance with ethical standards

Conflict of interest

The authors have no conflict of interest to disclose.

Ethical approval

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

Informed consent

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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Copyright information

© Springer-Verlag GmbH Germany, part of Springer Nature 2019

Authors and Affiliations

  1. 1.Department of Obstetrics and Gynecology, Poitiers University HospitalPoitiers UniversityPoitiersFrance
  2. 2.Movement - Interactions – Performance, MIP, EA 4334Nantes UniversitéNantesFrance
  3. 3.Health and Rehabilitation Research Institute, Faculty of Health and Environmental SciencesAuckland University of TechnologyAucklandNew Zealand
  4. 4.INSERM, Center for Research in Epidemiology and Population Health (CESP), U1018, Gender, Sexuality and Health TeamUniversity Paris-Sud, UMRS 1018OrsayFrance
  5. 5.INSERM, Poitiers University Hospital, CIC 1402Poitiers UniversityPoitiersFrance

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