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01-07-2021 | Original Article

Finite element modeling of maximum stress in pelvic floor structures during the head expulsion (FINESSE) study

Authors: Hana Cechova, Vladimir Kalis, Linda Havelkova, Zdenek Rusavy, Pavel Fiala, Martina Rybarova, Ludek Hyncik, Ladislav Krofta, Khaled M. Ismail

Published in: International Urogynecology Journal | Issue 7/2021

Abstract

Introduction and hypothesis

Several studies have assessed birth-related deformations of the levator ani muscle (LAM) and perineum on models that depicted these elements in isolation. The main aim of this study was to develop a complex female pelvic floor computational model using the finite element method to evaluate points and timing of maximum stress at the LAM and perineum in relation to the birth process.

Methods

A three-dimensional computational model of the female pelvic floor was created and used to simulate vaginal birth based on data from previously described real-life MRI scans. We developed three models: model A (LAM without perineum); model B (perineum without LAM); model C (a combined model with both structures).

Results

The maximum stress in the LAM was achieved when the vertex was 9 cm below the ischial spines and measured 37.3 MPa in model A and 88.7 MPa in model C. The maximum stress in the perineum occurred at the time of distension by the suboocipito-frontal diameter and reached 86.7 MPa and 119.6 MPa in models B and C, respectively, while the stress in the posterior fourchette caused by the suboccipito-bregmatic diameter measured 36.9 MPa for model B and 39.8 MPa for model C.

Conclusions

Including perineal structures in a computational birth model simulation affects the level of stress at the LAM. The maximum stress at the LAM and perineum seems to occur when the head is lower than previously anticipated.

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Title: Finite element modeling of maximum stress in pelvic floor structures during the head expulsion (FINESSE) study
Authors: Hana Cechova
Vladimir Kalis
Linda Havelkova
Zdenek Rusavy
Pavel Fiala
Martina Rybarova
Ludek Hyncik
Ladislav Krofta
Khaled M. Ismail
Publication date: 01-07-2021
Publisher: Springer International Publishing
Published in: International Urogynecology Journal / Issue 7/2021
Print ISSN: 0937-3462
Electronic ISSN: 1433-3023
DOI: https://doi.org/10.1007/s00192-021-04769-z

Keynote webinar | Spotlight on medication adherence

Springer Medicine

Finite element modeling of maximum stress in pelvic floor structures during the head expulsion (FINESSE) study

Abstract

Introduction and hypothesis

Methods

Results

Conclusions

Keynote webinar | Spotlight on medication adherence

Springer Medicine

Abstract

Introduction and hypothesis

Methods

Results

Conclusions

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