Pelvic floor muscle injury during a difficult labor. Can tissue fatigue damage play a role?
| Autor: | Renato Natal Jorge, James A. Ashton-Miller, Marco Parente, Maria C P Vila Pouca, John O.L. DeLancey |
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| Rok vydání: | 2021 |
| Předmět: |
medicine.medical_specialty
Urology Fatigue damage Pelvic Floor Muscle Pelvic Organ Prolapse Article Indirect evidence Pregnancy Internal medicine parasitic diseases medicine Humans Difficult labor Pelvic organ business.industry Vaginal delivery Obstetrics and Gynecology Pelvic Floor Delivery Obstetric Muscle injury Dystocia Muscle Fatigue Cardiology Female Low-cycle fatigue business |
| Zdroj: | Int Urogynecol J |
| ISSN: | 1433-3023 0937-3462 |
| DOI: | 10.1007/s00192-021-05012-5 |
| Popis: | Pubovisceral muscle (PVM) injury during a difficult vaginal delivery leads to pelvic organ prolapse later in life. If one could address how and why the muscle injury originates, one might be able to better prevent these injuries in the future. In a recent review we concluded that many atraumatic injuries of the muscle-tendon unit are consistent with it being weakened by an accumulation of passive tissue damage during repetitive loading. While the PVM can tear due to a single overstretch at the end of the second stage of labor we hypothesize that it can also be weakened by an accumulation of microdamage and then tear after a series of submaximal loading cycles. We conclude that there is strong indirect evidence that low cycle fatigue of PVM passive tissue is a possible mechanism of its proximal failure. This has implications for finding new ways to better prevent PVM injury in the future. |
| Databáze: | OpenAIRE |
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