{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,4,29]],"date-time":"2026-04-29T12:49:53Z","timestamp":1777466993730,"version":"3.51.4"},"reference-count":42,"publisher":"Springer Science and Business Media LLC","issue":"2","license":[{"start":{"date-parts":[[2021,11,16]],"date-time":"2021-11-16T00:00:00Z","timestamp":1637020800000},"content-version":"tdm","delay-in-days":0,"URL":"https:\/\/www.springer.com\/tdm"},{"start":{"date-parts":[[2021,11,16]],"date-time":"2021-11-16T00:00:00Z","timestamp":1637020800000},"content-version":"vor","delay-in-days":0,"URL":"https:\/\/www.springer.com\/tdm"}],"content-domain":{"domain":["link.springer.com"],"crossmark-restriction":false},"short-container-title":["Int Urogynecol J"],"published-print":{"date-parts":[[2022,2]]},"DOI":"10.1007\/s00192-021-05012-5","type":"journal-article","created":{"date-parts":[[2021,11,16]],"date-time":"2021-11-16T11:07:01Z","timestamp":1637060821000},"page":"211-220","update-policy":"https:\/\/doi.org\/10.1007\/springer_crossmark_policy","source":"Crossref","is-referenced-by-count":5,"title":["Pelvic floor muscle injury during a difficult labor. Can tissue fatigue damage play a role?"],"prefix":"10.1007","volume":"33","author":[{"ORCID":"https:\/\/orcid.org\/0000-0003-3279-5285","authenticated-orcid":false,"given":"Maria C. P.","family":"Vila Pouca","sequence":"first","affiliation":[]},{"given":"Marco P. L.","family":"Parente","sequence":"additional","affiliation":[]},{"given":"Renato M.","family":"Natal Jorge","sequence":"additional","affiliation":[]},{"given":"John O. L.","family":"DeLancey","sequence":"additional","affiliation":[]},{"given":"James A.","family":"Ashton-Miller","sequence":"additional","affiliation":[]}],"member":"297","published-online":{"date-parts":[[2021,11,16]]},"reference":[{"key":"5012_CR1","doi-asserted-by":"publisher","first-page":"1485","DOI":"10.1111\/j.1471-0528.2010.02704.x","volume":"117","author":"KL Shek","year":"2010","unstructured":"Shek KL, Dietz HP. Intrapartum risk factors for levator trauma. BJOG. 2010;117:1485\u201392. https:\/\/doi.org\/10.1111\/j.1471-0528.2010.02704.x.","journal-title":"BJOG"},{"key":"5012_CR2","doi-asserted-by":"publisher","first-page":"188.e1","DOI":"10.1016\/j.ajog.2015.05.001","volume":"213","author":"JM Miller","year":"2015","unstructured":"Miller JM, Low LK, Zielinski R, et al. Evaluating maternal recovery from labor and delivery: bone and levator ani injuries. Am J Obstet Gynecol 2015;213:188.e1\u2013e11. https:\/\/doi.org\/10.1016\/j.ajog.2015.05.001.","journal-title":"Am J Obstet Gynecol"},{"key":"5012_CR3","doi-asserted-by":"publisher","first-page":"44","DOI":"10.1046\/j.0001-6349.2001.10182.x","volume":"81","author":"E Samuelsson","year":"2002","unstructured":"Samuelsson E, Ladfors L, Lindblom BG, Hagberg H. A prospective observational study on tears during vaginal delivery: occurrences and risk factors. Acta Obstet Gynecol Scand. 2002;81:44\u20139.","journal-title":"Acta Obstet Gynecol Scand"},{"key":"5012_CR4","doi-asserted-by":"publisher","first-page":"420","DOI":"10.1097\/GCO.0000000000000312","volume":"28","author":"JOL DeLancey","year":"2016","unstructured":"DeLancey JOL. What\u2019s new in the functional anatomy of pelvic organ prolapse? Curr Opin Obstet Gynecol. 2016;28:420\u20139. https:\/\/doi.org\/10.1097\/GCO.0000000000000312.","journal-title":"Curr Opin Obstet Gynecol"},{"key":"5012_CR5","doi-asserted-by":"publisher","first-page":"164","DOI":"10.1080\/0167482X.2017.1294155","volume":"39","author":"AS Lagan\u00e0","year":"2018","unstructured":"Lagan\u00e0 AS, La Rosa VL, Rapisarda AMC, Vitale SG. Pelvic organ prolapse: the impact on quality of life and psychological well-being. J Psychosom Obstet Gynecol. 2018;39:164\u20136. https:\/\/doi.org\/10.1080\/0167482X.2017.1294155.","journal-title":"J Psychosom Obstet Gynecol"},{"key":"5012_CR6","doi-asserted-by":"publisher","first-page":"266","DOI":"10.1196\/annals.1389.034","volume":"1101","author":"JA Ashton-Miller","year":"2007","unstructured":"Ashton-Miller JA, DeLancey JOL. Functional anatomy of the female pelvic floor. Ann N Y Acad Sci. 2007;1101:266\u201396. https:\/\/doi.org\/10.1196\/annals.1389.034.","journal-title":"Ann N Y Acad Sci"},{"issue":"8","key":"5012_CR7","doi-asserted-by":"publisher","first-page":"232596712110207","DOI":"10.1177\/23259671211020731","volume":"9","author":"MCP Vila Pouca","year":"2021","unstructured":"Vila Pouca MCP, Parente MPL, Natal Jorge RM, Ashton-Miller JA. Injuries in muscle-tendon-bone units: a systematic review considering the role of passive tissue fatigue. Orthop J Sport Med. 2021;9(8):23259671211020731. https:\/\/doi.org\/10.1177\/23259671211020731.","journal-title":"Orthop J Sport Med"},{"key":"5012_CR8","doi-asserted-by":"publisher","first-page":"2067","DOI":"10.1177\/0363546519854450","volume":"47","author":"J Chen","year":"2019","unstructured":"Chen J, Kim J, Shao W, et al. An anterior cruciate ligament failure mechanism. Am J Sports Med. 2019;47:2067\u201376. https:\/\/doi.org\/10.1177\/0363546519854450.","journal-title":"Am J Sports Med"},{"key":"5012_CR9","doi-asserted-by":"publisher","first-page":"153","DOI":"10.1016\/j.actbio.2020.09.056","volume":"118","author":"AH Lin","year":"2020","unstructured":"Lin AH, Allan AN, Zitnay JL, et al. Collagen denaturation is initiated upon tissue yield in both positional and energy-storing tendons. Acta Biomater. 2020;118:153\u201360. https:\/\/doi.org\/10.1016\/j.actbio.2020.09.056.","journal-title":"Acta Biomater"},{"key":"5012_CR10","doi-asserted-by":"publisher","first-page":"eaba2795","DOI":"10.1126\/sciadv.aba2795","volume":"6","author":"JL Zitnay","year":"2020","unstructured":"Zitnay JL, Jung GS, Lin AH, et al. Accumulation of collagen molecular unfolding is the mechanism of cyclic fatigue damage and failure in collagenous tissues. Sci Adv. 2020;6:eaba2795. https:\/\/doi.org\/10.1126\/sciadv.aba2795.","journal-title":"Sci Adv"},{"key":"5012_CR11","doi-asserted-by":"publisher","first-page":"107","DOI":"10.1097\/00132585-200311020-00004","volume":"11","author":"G Sassmannshausen","year":"2003","unstructured":"Sassmannshausen G, Mair SD. Musculotendinous injuries about the athletically active middle-aged knee. Sports Med Arthrosc. 2003;11:107\u201311. https:\/\/doi.org\/10.1097\/00132585-200311020-00004.","journal-title":"Sports Med Arthrosc"},{"key":"5012_CR12","doi-asserted-by":"publisher","first-page":"829","DOI":"10.1016\/S0021-9290(97)00033-X","volume":"30","author":"H Schechtman","year":"1997","unstructured":"Schechtman H, Bader DL. In vitro fatigue of human tendons. J Biomech. 1997;30:829\u201335. https:\/\/doi.org\/10.1016\/S0021-9290(97)00033-X.","journal-title":"J Biomech"},{"key":"5012_CR13","first-page":"106","volume":"11","author":"N Andarawis-Puri","year":"2011","unstructured":"Andarawis-Puri N, Flatow EL. Tendon fatigue in response to mechanical loading. J Musculoskelet Neuronal Interact. 2011;11:106\u201314.","journal-title":"J Musculoskelet Neuronal Interact"},{"key":"5012_CR14","doi-asserted-by":"publisher","DOI":"10.1007\/978-88-470-2336-9","volume-title":"Fatigue and corrosion in metals","author":"PP Milella","year":"2013","unstructured":"Milella PP. Fatigue and corrosion in metals. 1st ed. Milan: Springer-Verlag; 2013.","edition":"1"},{"key":"5012_CR15","doi-asserted-by":"publisher","first-page":"484","DOI":"10.1016\/j.ajog.2015.10.926","volume":"214","author":"KJ Leveno","year":"2016","unstructured":"Leveno KJ, Nelson DB, McIntire DD. Second-stage labor: how long is too long? Am J Obstet Gynecol. 2016;214:484\u20139. https:\/\/doi.org\/10.1016\/j.ajog.2015.10.926.","journal-title":"Am J Obstet Gynecol"},{"key":"5012_CR16","doi-asserted-by":"publisher","first-page":"873","DOI":"10.1097\/AOG.0b013e31819c82e1","volume":"113","author":"K-C Lien","year":"2009","unstructured":"Lien K-C, DeLancey JOL, Ashton-Miller JA. Biomechanical analyses of the efficacy of patterns of maternal effort on second-stage progress. Obstet Gynecol. 2009;113:873\u201380. https:\/\/doi.org\/10.1097\/AOG.0b013e31819c82e1.","journal-title":"Obstet Gynecol"},{"key":"5012_CR17","doi-asserted-by":"publisher","first-page":"e433","DOI":"10.1016\/j.wombi.2018.10.005","volume":"32","author":"N Lee","year":"2019","unstructured":"Lee N, Gao Y, Lotz L, Kildea S. Maternal and neonatal outcomes from a comparison of spontaneous and directed pushing in second stage. Women Birth. 2019;32:e433\u201340. https:\/\/doi.org\/10.1016\/j.wombi.2018.10.005.","journal-title":"Women Birth"},{"key":"5012_CR18","doi-asserted-by":"publisher","first-page":"163","DOI":"10.1146\/annurev-bioeng-061008-124823.On","volume":"11","author":"JA Ashton-Miller","year":"2009","unstructured":"Ashton-Miller JA, DeLancey JOL. On the biomechanics of vaginal birth and common sequelae. Annu Rev Biomed Eng. 2009;11:163\u201376. https:\/\/doi.org\/10.1146\/annurev-bioeng-061008-124823.On.","journal-title":"Annu Rev Biomed Eng"},{"key":"5012_CR19","doi-asserted-by":"publisher","first-page":"64","DOI":"10.1016\/j.jbiomech.2018.04.019","volume":"74","author":"PV Tracy","year":"2018","unstructured":"Tracy PV, Wadhwani S, Triebwasser J, et al. On the variation in maternal birth canal in vivo viscoelastic properties and their effect on the predicted length of active second stage and levator ani tears. J Biomech. 2018;74:64\u201371. https:\/\/doi.org\/10.1016\/j.jbiomech.2018.04.019.","journal-title":"J Biomech"},{"key":"5012_CR20","doi-asserted-by":"publisher","first-page":"13","DOI":"10.4161\/org.27404","volume":"10","author":"BB Rothrauff","year":"2014","unstructured":"Rothrauff BB, Tuan RS. Cellular therapy in bone-tendon interface regeneration. Organogenesis. 2014;10:13\u201328. https:\/\/doi.org\/10.4161\/org.27404.","journal-title":"Organogenesis"},{"key":"5012_CR21","doi-asserted-by":"publisher","first-page":"131","DOI":"10.1007\/978-3-662-54184-5_13","volume-title":"Muscle and tendon injuries: evaluation and management","author":"N Sevivas","year":"2017","unstructured":"Sevivas N, Fran\u00e7a G, Oliveira N, et al. Biomaterials for tendon regeneration\u2014. In: Canata GL, d\u2019Hooghe P, Hunt KJ, editors. Muscle and tendon injuries: evaluation and management. Berlin, Heidelberg: Springer; 2017. p. 131\u201343."},{"key":"5012_CR22","doi-asserted-by":"publisher","first-page":"409","DOI":"10.1016\/B978-1-78242-301-0.00017-3","volume-title":"Regenerative engineering of musculoskeletal tissues and interfaces","author":"K VanDusen","year":"2015","unstructured":"VanDusen K, Larkin L. Muscle-tendon interface. In: Regenerative engineering of musculoskeletal tissues and interfaces. Cambridge: Woodhead Publishing; 2015. p. 409\u201329."},{"key":"5012_CR23","doi-asserted-by":"publisher","first-page":"774","DOI":"10.1002\/nau.22649","volume":"34","author":"J Kim","year":"2015","unstructured":"Kim J, Betschart C, Ramanah R, et al. Anatomy of the pubovisceral muscle origin: macroscopic and microscopic findings within the injury zone. Neurourol Urodyn. 2015;34:774\u201380. https:\/\/doi.org\/10.1002\/nau.22649.","journal-title":"Neurourol Urodyn"},{"key":"5012_CR24","doi-asserted-by":"publisher","first-page":"48","DOI":"10.1097\/BLO.0b013e31802ca45b","volume":"454","author":"T Zantop","year":"2007","unstructured":"Zantop T, Brucker PU, Vidal A, et al. Intraarticular rupture pattern of the ACL. Clin Orthop Relat Res. 2007;454:48\u201353. https:\/\/doi.org\/10.1097\/BLO.0b013e31802ca45b.","journal-title":"Clin Orthop Relat Res"},{"key":"5012_CR25","doi-asserted-by":"publisher","first-page":"1058","DOI":"10.1177\/0363546513477836","volume":"41","author":"DB Lipps","year":"2013","unstructured":"Lipps DB, Wojtys EM, Ashton-Miller JA. Anterior cruciate ligament fatigue failures in knees subjected to repeated simulated pivot landings. Am J Sports Med. 2013;41:1058\u201366. https:\/\/doi.org\/10.1177\/0363546513477836.","journal-title":"Am J Sports Med"},{"key":"5012_CR26","doi-asserted-by":"publisher","first-page":"68","DOI":"10.1016\/j.matbio.2019.07.008","volume":"85\u201386","author":"T Stauber","year":"2020","unstructured":"Stauber T, Blache U, Snedeker JG. Tendon tissue microdamage and the limits of intrinsic repair. Matrix Biol. 2020;85\u201386:68\u201379. https:\/\/doi.org\/10.1016\/j.matbio.2019.07.008.","journal-title":"Matrix Biol"},{"key":"5012_CR27","doi-asserted-by":"publisher","first-page":"58","DOI":"10.1016\/j.actbio.2017.03.024","volume":"56","author":"CT Thorpe","year":"2017","unstructured":"Thorpe CT, Riley GP, Birch HL, et al. Fascicles and the interfascicular matrix show decreased fatigue life with ageing in energy storing tendons. Acta Biomater. 2017;56:58\u201364. https:\/\/doi.org\/10.1016\/j.actbio.2017.03.024.","journal-title":"Acta Biomater"},{"issue":"1","key":"5012_CR28","doi-asserted-by":"publisher","first-page":"144","DOI":"10.1097\/01.AOG.0000194063.63206.1c","volume":"107","author":"R Kearney","year":"2006","unstructured":"Kearney R, Miller JM, Ashton-Miller JA, DeLancey JOL. Obstetric factors associated with levator ani muscle injury after vaginal birth. Obstet Gynecol 2006;107(1):144-9.","journal-title":"Obstet Gynecol"},{"key":"5012_CR29","doi-asserted-by":"publisher","first-page":"257","DOI":"10.1177\/036354659402200217","volume":"22","author":"TJ Noonan","year":"1994","unstructured":"Noonan TJ, Best TM, Seaber AV, Garrett WEJ. Identification of a threshold for skeletal muscle injury. Am J Sports Med. 1994;22:257\u201361. https:\/\/doi.org\/10.1177\/036354659402200217.","journal-title":"Am J Sports Med"},{"key":"5012_CR30","doi-asserted-by":"publisher","first-page":"190","DOI":"10.1177\/036354659302100205","volume":"21","author":"DC Taylor","year":"1993","unstructured":"Taylor DC, Dalton JDJ, Seaber AV, Garrett WEJ. Experimental muscle strain injury. Early functional and structural deficits and the increased risk for reinjury. Am J Sports Med. 1993;21:190\u20134. https:\/\/doi.org\/10.1177\/036354659302100205.","journal-title":"Am J Sports Med"},{"key":"5012_CR31","doi-asserted-by":"publisher","first-page":"509","DOI":"10.1016\/S8756-3282(01)00696-2","volume":"30","author":"YN Yeni","year":"2002","unstructured":"Yeni YN, Fyhrie DP. Fatigue damage-fracture mechanics interaction in cortical bone. Bone. 2002;30:509\u201314. https:\/\/doi.org\/10.1016\/S8756-3282(01)00696-2.","journal-title":"Bone"},{"key":"5012_CR32","doi-asserted-by":"publisher","first-page":"101480","DOI":"10.1016\/j.redox.2020.101480","volume":"35","author":"AJ Cheng","year":"2020","unstructured":"Cheng AJ, Jude B, Lanner JT. Intramuscular mechanisms of overtraining. Redox Biol. 2020;35:101480. https:\/\/doi.org\/10.1016\/j.redox.2020.101480.","journal-title":"Redox Biol"},{"key":"5012_CR33","first-page":"381","volume-title":"Microscopy and analysis","author":"K Miura","year":"2016","unstructured":"Miura K. Application of scanning acoustic microscopy to pathological diagnosis. In: Stanciu S, editors Microscopy and analysis. Rijeka: IntechOpen; 2016. p. 381\u2013403."},{"key":"5012_CR34","doi-asserted-by":"publisher","DOI":"10.1016\/j.heliyon.2021.e07847","volume":"7","author":"K Miura","year":"2021","unstructured":"Miura K, Fukushi Y. Scanning acoustic microscopy imaging of cellular structural and mechanical alterations from external stimuli. Heliyon. 2021;7:e07847. https:\/\/doi.org\/10.1016\/j.heliyon.2021.e07847.","journal-title":"Heliyon"},{"key":"5012_CR35","doi-asserted-by":"publisher","first-page":"25","DOI":"10.1186\/s42649-020-00045-4","volume":"50","author":"H Yu","year":"2020","unstructured":"Yu H. Scanning acoustic microscopy for material evaluation. Appl Microsc. 2020;50:25. https:\/\/doi.org\/10.1186\/s42649-020-00045-4.","journal-title":"Appl Microsc"},{"key":"5012_CR36","doi-asserted-by":"publisher","first-page":"683","DOI":"10.1002\/nau.22781","volume":"35","author":"AS Da Silva","year":"2016","unstructured":"Da Silva AS, Digesu GA, Dell\u2019Utri C, et al. Do ultrasound findings of levator ani \u201cavulsion\u201d correlate with anatomical findings: a multicenter cadaveric study. Neurourol Urodyn. 2016;35:683\u20138. https:\/\/doi.org\/10.1002\/nau.22781.","journal-title":"Neurourol Urodyn"},{"key":"5012_CR37","doi-asserted-by":"publisher","first-page":"123","DOI":"10.1002\/nau.23847","volume":"38","author":"AS Da Silva","year":"2019","unstructured":"Da Silva AS, Asfour V, Digesu GA, et al. Levator ani avulsion: the histological composition of this site. A cadaveric study. Neurourol Urodyn. 2019;38:123\u20139. https:\/\/doi.org\/10.1002\/nau.23847.","journal-title":"Neurourol Urodyn"},{"key":"5012_CR38","doi-asserted-by":"publisher","first-page":"29","DOI":"10.1093\/humupd\/dmr040","volume":"18","author":"L Schmidt","year":"2012","unstructured":"Schmidt L, Sobotka T, Bentzen JG, Nyboe Andersen A. Demographic and medical consequences of the postponement of parenthood. Hum Reprod Update. 2012;18:29\u201343. https:\/\/doi.org\/10.1093\/humupd\/dmr040.","journal-title":"Hum Reprod Update"},{"key":"5012_CR39","doi-asserted-by":"publisher","first-page":"43","DOI":"10.1016\/0002-9378(63)90075-9","volume":"86","author":"WH Pearse","year":"1963","unstructured":"Pearse WH. Electronic recording of forceps delivery. Am J Obstet Gynecol. 1963;86:43\u201351. https:\/\/doi.org\/10.1016\/0002-9378(63)90075-9.","journal-title":"Am J Obstet Gynecol"},{"key":"5012_CR40","doi-asserted-by":"publisher","first-page":"273","DOI":"10.1097\/00005131-200204000-00010","volume":"16","author":"A Pina","year":"2002","unstructured":"Pina A, Garcia I, Sabater M. Traumatic avulsion of the triceps brachii. J Orthop Trauma. 2002;16:273\u20136. https:\/\/doi.org\/10.1097\/00005131-200204000-00010.","journal-title":"J Orthop Trauma"},{"key":"5012_CR41","doi-asserted-by":"publisher","first-page":"31","DOI":"10.1097\/01.AOG.0000109207.22354.65","volume":"103","author":"K-C Lien","year":"2004","unstructured":"Lien K-C, Mooney B, DeLancey JOL, Ashton-Miller JA. Levator ani muscle stretch induced by simulated vaginal birth. Obstet Gynecol. 2004;103:31\u201340. https:\/\/doi.org\/10.1097\/01.AOG.0000109207.22354.65.","journal-title":"Obstet Gynecol"},{"key":"5012_CR42","doi-asserted-by":"publisher","first-page":"213","DOI":"10.1016\/j.jmbbm.2017.12.025","volume":"79","author":"PV Tracy","year":"2018","unstructured":"Tracy PV, Wineman AS, Orejuela FJ, et al. A constitutive model description of the in vivo material properties of lower birth canal tissue during the first stage of labor. J Mech Behav Biomed Mater. 2018;79:213\u20138. https:\/\/doi.org\/10.1016\/j.jmbbm.2017.12.025.","journal-title":"J Mech Behav Biomed Mater"}],"container-title":["International Urogynecology Journal"],"original-title":[],"language":"en","link":[{"URL":"https:\/\/link.springer.com\/content\/pdf\/10.1007\/s00192-021-05012-5.pdf","content-type":"application\/pdf","content-version":"vor","intended-application":"text-mining"},{"URL":"https:\/\/link.springer.com\/article\/10.1007\/s00192-021-05012-5\/fulltext.html","content-type":"text\/html","content-version":"vor","intended-application":"text-mining"},{"URL":"https:\/\/link.springer.com\/content\/pdf\/10.1007\/s00192-021-05012-5.pdf","content-type":"application\/pdf","content-version":"vor","intended-application":"similarity-checking"}],"deposited":{"date-parts":[[2022,1,31]],"date-time":"2022-01-31T13:06:23Z","timestamp":1643634383000},"score":1,"resource":{"primary":{"URL":"https:\/\/link.springer.com\/10.1007\/s00192-021-05012-5"}},"subtitle":[],"short-title":[],"issued":{"date-parts":[[2021,11,16]]},"references-count":42,"journal-issue":{"issue":"2","published-print":{"date-parts":[[2022,2]]}},"alternative-id":["5012"],"URL":"https:\/\/doi.org\/10.1007\/s00192-021-05012-5","relation":{},"ISSN":["0937-3462","1433-3023"],"issn-type":[{"value":"0937-3462","type":"print"},{"value":"1433-3023","type":"electronic"}],"subject":[],"published":{"date-parts":[[2021,11,16]]},"assertion":[{"value":"2 August 2021","order":1,"name":"received","label":"Received","group":{"name":"ArticleHistory","label":"Article History"}},{"value":"12 October 2021","order":2,"name":"accepted","label":"Accepted","group":{"name":"ArticleHistory","label":"Article History"}},{"value":"16 November 2021","order":3,"name":"first_online","label":"First Online","group":{"name":"ArticleHistory","label":"Article History"}},{"order":1,"name":"Ethics","group":{"name":"EthicsHeading","label":"Declarations"}},{"value":"M.C.P.V.P., M.P.L.P. and R.M.N.J. declare no conflicts of interest. J.O.L.D. and J.A.A-M.\u2019s institution received US National Institutes of Health Grant R44 HD 096987 for them to analyze the Materna LLC Prep device data on the relationship between birth canal dilation force and displacement during the first stage of labor.","order":2,"name":"Ethics","group":{"name":"EthicsHeading","label":"Conflicts of interests"}}]}}