The management of episiotomy technique and its effect on pelvic floor muscles during a malposition childbirth

• Type: Article in International Scientific Journal
• Date: 2017

Authors

Oliveira, DA (Author) Other; Parente, MPL (Author) FEUP; Calvo, B (Author) Other; mascarenhas, t (Author) FMUP; Renato Natal Jorge (Author) FEUP

Journal

Title: Computer Methods in Biomechanics and Biomedical Engineering

Vol. 20 No. 6

Pages: 1249-1259

ISSN: 1025-5842

Publisher: Taylor & Francis

Indexing

ISI Web of Knowledge - 6 Citations

Scopus - 8 Citations

Other information

Authenticus ID: P-00Q-2HR

DOI: 10.1080/10255842.2017.1349762

Abstract (EN): Vaginal childbirth is the leading cause of pelvic floor muscles injury, which contributes to pelvic floor dysfunction, being enhanced by fetal malposition. Therefore, the aim of the present study is to verify the influence of mediolateral episiotomies in the mechanics of the pelvic floor with the fetus in occiput posterior position when compared to the occiput anterior position. Numerical simulations of vaginal deliveries, with and without episiotomy, are performed based on the Finite Element Method. The biomechanical model includes the pelvic floor muscles, a surface to delimit the anterior region of the birth canal and a fetus. Fetal malposition induces greater extension of the muscle compared to the normal position, leading to increases of stretch. The faster enlargement may be responsible for a prolonged second stage of labor. Regarding the force required to achieve delivery, the difference between the analyzed cases are 35N, which might justify the increased need of surgical interventions. Furthermore, episiotomy is essential in reducing the damage to values near the ones obtained with normal position, making the fetal position irrelevant. These biomechanical models have become extremely useful tools to provide some understanding of pelvic floor function during delivery helping in the development of preventative strategies.

Language: English

Type (Professor's evaluation): Scientific

No. of pages: 11