ArticleInternational urogynecology journal2020
Persistent occiput posterior position and stress distribution in levator ani muscle during vaginal delivery computed by a finite element model.
Article in International urogynecology journal, 2020. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 10 papers, 1 of them a synthesis that pooled it.
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Who cites it
10 citing papers in PubMed, 1 synthesis or guideline pooled it, 20 citations in OpenAlex.
- Maternal Positioning in the Second Stage of Labour and its Relationship with Perineal Trauma: A Systematic Review and Network Meta-Analysis.International urogynecology journal · 2026Pooled it
- Prediction of late-pregnancy pelvic floor dysfunction: a nomogram model based on proton density fat fraction and synthetic magnetic resonance imaging.Quantitative imaging in medicine and surgery · 2026Article
- Biomechanical Model of the Levator Ani Muscle: Identifying the Greatest Strain Areas in Its Subdivisions.International urogynecology journal · 2026Article
- Finite element modeling in obstetrics and gynecology: advances, applications, and challenges.Frontiers in medicine · 2025Review
- The significance of positional care combined with doula delivery during childbirth in the correction of abnormal fetal position.American journal of translational research · 2024Article
- Finite element analysis of female pelvic organ prolapse mechanism: current landscape and future opportunities.Frontiers in medicine · 2024Review
- Analysis of questions by patients with pelvic organ prolapse about vaginal pessaries resulting in a checklist for their physicians.Archives of gynecology and obstetrics · 2024Article
- Effects of yoga on the intervention of levator ani hiatus in postpartum women: a prospective study.Journal of physical therapy science · 2021Article
- Finite element modeling of maximum stress in pelvic floor structures during the head expulsion (FINESSE) study.International urogynecology journal · 2021Article
- Feasibility and safety of antepartum tactile imaging.International urogynecology journal · 2021Article
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Authors and funding
6 authors at 2 institutions in 1 country.
Funding
Abstract
introduction and hypothesisObjective of this study was to develop an MRI-based finite element model and simulate a childbirth considering the fetal head position in a persistent occiput posterior position.
methodsThe model involves the pelvis, fetal head and soft tissues including the levator ani and obturator muscles simulated by the hyperelastic nonlinear Ogden material model. The uniaxial test was measured using pig samples of the levator to determine the material constants. Vaginal deliveries considering two positions of the fetal head were simulated: persistent occiput posterior position and uncomplicated occiput anterior position. The von Mises stress distribution was analyzed.
resultsThe material constants of the hyperelastic Ogden model were measured for the samples of pig levator ani. The mean values of Ogden parameters were calculated as: μ1 = 8.2 ± 8.9 GPa; μ2 = 21.6 ± 17.3 GPa; α1 = 0.1803 ± 0.1299; α2 = 15.112 ± 3.1704. The results show the significant increase of the von Mises stress in the levator muscle for the case of a persistent occiput posterior position. For the optimal head position, the maximum stress was found in the anteromedial levator portion at station +8 (mean: 44.53 MPa). For the persistent occiput posterior position, the maximum was detected in the distal posteromedial levator portion at station +6 (mean: 120.28 MPa).
conclusionsThe fetal head position during vaginal delivery significantly affects the stress distribution in the levator muscle. Considering the persistent occiput posterior position, the stress increases evenly 3.6 times compared with the optimal head position.
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