Displacement and recovery of the vesical neck position during pregnancy and after childbirth.
OBJECTIVE
(i) To describe the displacement and recovery of the vesical neck position during pregnancy and after childbirth and (ii) to discriminate between compliance of the vesical neck supporting structures with and without pelvic floor contraction.


METHODS
We focussed on the biomechanical properties of the vesical neck supporting structures during pregnancy and after childbirth by calculating the compliance and the hysteresis as a result from of abdominal pressure measurements and simultaneous perineal ultrasound.


RESULTS
This study shows that compliance of the supporting structures remains relatively constant during pregnancy and returns to normal values 6 months after childbirth. Hysteresis, however, showed an increase after childbirth, persisting at least until 6 months post partum.


CONCLUSIONS
Vaginal delivery may stretch and or load beyond the physiological properties of the pelvic floor tissue and in this way may lead to irreversible changes in tissue properties which play an important role in the urethral support continence mechanism.
Wijma
Jacobus
J
Martini Hospital Groningen, Groningen, The Netherlands. jac.wijma@wanadoo.nl
Weis Potters
Annemarie E
AE
van der Mark
Thomas W
TW
Tinga
Dick J
DJ
Aarnoudse
Jan G
JG
D000293:Adolescent; D000328:Adult; D001696:Biomechanical Phenomena; D003187:Compliance; D036861:Delivery, Obstetric; D005260:Female; D006801:Humans; D009119:Muscle Contraction / Q000502:physiology; D018482:Muscle, Skeletal / Q000502:physiology; D036801:Parturition; D017773:Pelvic Floor / Q000000981:diagnostic imaging / Q000502:physiology*; D049590:Postpartum Period / Q000502:physiology*; D011247:Pregnancy / Q000502:physiology*; D011446:Prospective Studies; D014463:Ultrasonography; D014521:Urethra / Q000000981:diagnostic imaging / Q000502:physiology*; D001743:Urinary Bladder / Q000000981:diagnostic imaging / Q000502:physiology*; D014636:Valsalva Maneuver / Q000502:physiology