By Marine Lallemant on the Future of Childbirth Monitoring: Can we predict pelvic floor trauma before it happens?
Each year, millions of women give birth vaginally and for many, this incredible moment is marred by the reality of perineal injury. Perineal tears are among the most frequent complications of childbirth, affecting up to 80% of women. While minor tears may heal quickly, more severe injuries, especially those affecting the anal sphincter complex, can result in lasting pain, incontinence, sexual dysfunction, and psychological distress.
Why are these injuries so hard to predict?
The perineum is a complex structure of muscles and connective tissue, essential for continence and pelvic organs support. Its biomechanical behavior during childbirth is unique to every woman, shaped by factors like tissue elasticity and anatomy. Furthermore, the dynamics of birth, which are not only unique to each woman, but to each individual labor for the same woman are other important factors. Traditional risk factors, such as first-time vaginal delivery, use of forceps, a big baby, or prolonged labor, are helpful risk indictors, but far from precise. Indeed, many women with known risk factors deliver without injury, while others suffer severe tears unexpectedly.
Clinicians currently rely on their expertise, visual assessment, and manual perineal protection techniques to minimize trauma during birth. While these approaches are valuable, they remain subjective and provide limited real-time information about the actual tension and stress exerted on the perineal tissues. This subjectivity makes it difficult to anticipate and prevent injuries as they occur. Recent advances in biomechanical modelling and imaging have shown that factors like tissue stiffness and perineal measurements may influence risk, but these approaches are not yet part of routine clinical practice.
The innovation: Real-time, personalised monitoring
This is where the PELVITRACK project aims to revolutionise care. Supported by the European Innovation Council, PELVITRACK brings together clinicians, biomedical engineers, researchers, scientists, and healthcare professionals from diverse backgrounds to build the first real-time pelvic floor monitoring system for childbirth. By integrating advanced imaging techniques (such as ultrasound elastography and stereophotogrammetry), biomechanical and numerical modeling, patient-specific simulations, detailed biomechanical and biometric analyses (both ex vivo and in vivo), and state-of-the-art machine learning algorithms, PELVITRACK aims to generate objective, real-time data for perineal tissues’ properties and deformations that occur at the time of birth. This multidisciplinary approach will support clinicians with precise, actionable information, enabling tailored interventions and opening new avenues for research and prevention of perineal injuries.
Imagine a future where birth attendants are guided by live, personalised data on each woman’s pelvic floor making it possible to act quickly and effectively to protect patients from the risk of severe tears and their lifelong impact.
A new era for women’s health
The impact of perineal trauma extends far beyond the delivery room. By moving from reactive to predictive care, PELVITRACK’s technology could revolutionise maternal health and quality of life worldwide. Our journey, spanning laboratory research, clinical innovation, and multidisciplinary collaboration, reflects our vision - “No woman should endure preventable trauma during childbirth”.
With continued innovation and multi-disciplinary teamwork, we are closer than ever to answering a crucial question: Can we predict and prevent pelvic floor trauma before it happens? Thanks to PELVITRACK, the future of childbirth monitoring is not just imaginable, but achievable.
Dr. Marine Lallemant, MD, PhD
Gynecologist-Obstetrician, Urogynecologist Specialist
PELVITRACK Consortium