Levator ani muscle stretch induced by simulated vaginal birth
Levator ani muscle stretch induced by simulated vaginal birth
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DOI：
10.1097/01.aog.0000109207.22354.65
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发表时间：
2004-01-01
影响因子：
7.2
通讯作者：
Ashton-Miller, JA
中科院分区：
文献类型：
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作者：
Lien, KC;Mooney, B;Ashton-Miller, JA
目的：为了开发一个三维计算机模型来预测肛提肌伸展阴道birth.METHODS：从一个健康的未经产的34岁的女性，已发表的解剖数据，和工程图形软件的序列磁共振图像被用来构建一个结构模型的肛提肌沿着与相关的被动组织。该模型被用来量化骨盆底肌肉拉伸诱导在第二产程作为一个模型胎头逐步从事，然后拉伸髂尾肌，耻尾肌，和耻骨直肠肌muscles.RESULTS：最大的组织应变达到拉伸比（组织长度下拉伸/原始组织长度）为3.26，在内侧耻尾肌，最短，最内侧和腹侧提肛肌。回尾肌、耻尾肌和耻骨直肠肌的最大拉伸比分别为2.73、2.50和2.28。组织拉伸比成比例的胎儿头部大小：例如，增加9%的胎儿头部直径增加内侧耻骨尾骨肌拉伸相同amount.CONCLUSION：内侧耻骨尾骨肌进行最大的拉伸任何肛提肌在阴道分娩。因此，他们是在最大的风险拉伸相关的伤害。(C)2004年由美国妇产科医师学会。
OBJECTIVE: To develop a three-dimensional computer model to predict levator ani muscle stretch during vaginal birth.METHODS: Serial magnetic resonance images from a healthy nulliparous 34-year-old woman, published anatomic data, and engineering graphics software were used to construct a structural model of the levator ani muscles along with related passive tissues. The model was used to quantify pelvic floor muscle stretch induced during the second stage of labor as a model fetal head progressively engaged and then stretched the iliococcygeus, pubococcygeus, and puborectalis muscles.RESULTS: The largest tissue strain reached a stretch ratio (tissue length under stretch/original tissue length) of 3.26 in medial pubococcygeus muscle, the shortest, most medial and ventral levator ani muscle. Regions of the ileococcygeus, pubococcygeus, and puborectalis muscles readied maximal stretch ratios of 2.73, 2.50, and 2.28, respectively. Tissue stretch ratios were proportional to fetal head size: For example, increasing fetal head diameter by 9% increased medial pubococcygeus stretch by the same amount.CONCLUSION: The medial pubococcygeus muscles undergo the largest stretch of any levator ani muscles during vaginal birth. They are therefore at the greatest risk for stretch related injury. (C) 2004 by The American College of Obstetricians and Gynecologists.