![]() The study was approved by the local ethics committee of the authors' institution. ![]() The objective of this study was to develop a sophisticated MRI-based finite element model of the female pelvic floor to simulate a child birth for fetal head position in persistent OP and analyze the stress distribution in the LAM with respect to the cardinal movements of labor. To the authors' knowledge, there are no studies describing the material properties of non-cadaveric LAM. Material properties are usually derived from cadaveric LAM uniaxial or biaxial tests. Although these models provide satisfactory insights, they are strongly limited by constitutive data or boundary conditions representing the real anatomy and physiology. Most of them are focused on the second stage of labor, starting from full dilatation of the cervix to the birth of the fetus. Several virtual models of VD have already been developed. This condition is found in up to 5% of deliveries and occurs significantly more often in first labors. Ī persistent occiput posterior (OP) position in the second stage of delivery carries an increased risk of labor complications, obstetric interventions, severe maternal perineal lacerations and anal sphincter injury. This trauma usually causes lifelong complications. These deformations can lead to injuries such as muscle tearing and striated muscle atrophy, owing to pudendal denervation. During VD, the LAM undergoes extremely large deformations to allow the passage of the fetal head. ![]() LAM injuries occur in 13–36% of women who have vaginal delivery (VD), and there is conclusive evidence of a connection between these injuries and pelvic floor dysfunction (PFD). In recent years with advances in magnetic resonance imaging (MRI) and four-dimensional sonography, it has also become evident that levator ani muscle (LAM) injuries represent an important part of pelvic floor trauma. ![]() In the past decades, the concept of pelvic floor trauma was attributed largely to perineal, vaginal and anal sphincter injuries. ![]()
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