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Perineal Mapping

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Book cover Perineal Trauma at Childbirth

Abstract

Perineal mapping is the complex analysis of the impact of anatomical conditions and interventions during the final phase of vaginal birth on risk of maternal perineal trauma. It includes tests on physical or computational models, experimental measurements on human tissues or clinical evaluation of different factors at the time of birth.

Experimental perineal mapping utilises data obtained from different sources such as stereophotogrammetry, virtual simulations, direct physical measurements and ultrasonography or other imaging techniques. Clinical perineal mapping involves data analysis based on the size of the fetal head, length/diameter of the genital hiatus, dimensions and elasticity of the perineal tissues or the co-operation of the parturient. This allows for individualised selection of certain modifications from a set of obstetric interventions e.g. use of obstetric gel, type and timing of episiotomy, manual perineal protection, slowing of the passage of the fetal head, second stage perineal massage, local application of warm packs. These interventions are employed to decrease frictional forces, increase the diameter of the vaginal introitus, decrease the size of the passing object, disperse/decrease the perineal tension, increase the elasticity of the perineum and/or control the speed of the delivery of the fetus and to harmonize all complex processes with the maternal efforts.

With the use of perineal mapping, an international classification of episiotomies has been developed and the effectiveness of manual perineal protection has been evaluated based on biomechanical principles while considering a variety of its modifications. Other interventions are in line for future analysis.

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Acknowledgments

The work on this chapter was supported by the Charles University Research Fund (Progres Q39) and by the National Sustainability Program I (NPU I) Nr. LO1503 provided by the Ministry of Education, Youth and Sports of the Czech Republic and by the project SGS-2016-059 (Computer modeling and monitoring of human body used for medicine) of the University of West Bohemia.

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Authors and Affiliations

  1. Department of Gynecology and Obstetrics, Biomedical Center, Faculty of Medicine, Charles University and University Hospital Pilsen, Pilsen, Czech Republic

    Vladimir Kalis MD, PhD & Zdenek Rusavy MD, PhD

  2. New Technologies – Research Centre, University of West Bohemia, Pilsen, Czech Republic

    Magdalena Jansova PhD

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  1. Vladimir Kalis MD, PhD
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  2. Magdalena Jansova PhD
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  3. Zdenek Rusavy MD, PhD
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Correspondence to Vladimir Kalis MD, PhD .

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  1. University of Birmingham, Birmingham, United Kingdom

    Khaled M. K. Ismail

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Kalis, V., Jansova, M., Rusavy, Z. (2016). Perineal Mapping. In: Ismail, K. (eds) Perineal Trauma at Childbirth. Springer, Cham. https://doi.org/10.1007/978-3-319-14860-1_3

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