Mechanical Effects of a Maylard Scar During a Vaginal Birth After a Previous Caesarean

• Tipo: Artigo em Revista Científica Internacional
• Data: 2021

Autores

Fidalgo, DS (Autor) Outra; Pouca, MCPV (Autor) Outra; Oliveira, DA (Autor) Outra; Malanowska, E (Autor) Outra; Myers, KM (Autor) Outra; Renato Natal Jorge (Autor) FEUP; Parente, MPL (Autor) FEUP

Revista

Título: Annals of Biomedical Engineering

Vol. 49

Páginas: 3593-3608

ISSN: 0090-6964

Editora: Springer Nature

Indexação

ISI Web of Knowledge - 0 Citações

Scopus - 0 Citações

Outras Informações

ID Authenticus: P-00V-1Z2

DOI: 10.1007/s10439-021-02805-z

Abstract (EN): Caesarean section is one of the most common surgeries worldwide, even though there is no evidence supporting maternal and perinatal long-term benefits. Furthermore, the mechanical behavior of a caesarean scar during a vaginal birth after caesarean (VBAC) is not well understood since there are several questions regarding the uterine wound healing process. The aim of this study is to investigate the biomechanical Maylard fiber reorientation and stiffness influence during a VBAC through computational methods. A biomechanical model comprising a fetus and a uterus was developed, and a chemical-mechanical constitutive model that triggers uterine contractions was used, where some of the parameters were adjusted to account for the matrix and fiber stiffness increase in the caesarean scar. Several mechanical simulations were performed to analyze different scar fibers arrangements, considering different values for the respective matrix and fibers stiffness. The results revealed that a random fiber arrangement in the Maylard scar has a much higher impact on its mechanical behavior during a VBAC than the common fibers arrangement present in the uninjured uterine tissue. An increase of the matrix scar stiffness exhibits a lower impact, while an increase of the fiber's stiffness has no significant influence.

Idioma: Inglês

Tipo (Avaliação Docente): Científica

Nº de páginas: 16