Antenatal pelvic floor biometry is related to levator ani muscle injury

Chan, Symphorosa Shing Chee; Cheung, Ray C. C.; Yiu, K W; Lee, L.L.; Chung, Tony K.H.

doi:10.1002/uog.15787

Cited by 3 publications

(5 citation statements)

References 26 publications

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“…A total of 37 primary non‐randomised studies from 17 countries and involving 5594 women were included in our systematic review (Figure 1, Tables S4, S5). 9,13,21–55 All studies were reported in English with the exception of one study, which was in Czech, and hence the authors undertook the translation.…”

Section: Resultsmentioning

confidence: 99%

“…studies because of their effect on statistical heterogeneity. A total of eight, 27,31,33,42,45,51,53,54 six, 9,23,28–30,55 eight, 13,21,22,38,39,41,45,50 nine 25,26,32,33,36,46–48,52 and six 24,34,37,40,44,56 studies reported performing their imaging modality to assess LA at 0–1, >1–3, >3–6, >6–12 and >12 months after birth. respectively.…”

Section: Resultsmentioning

confidence: 99%

“…Incidence rate of LA depending on timing of imaging after birth Similar to the incidence rate of LA by imaging modality we did not include the Aydin et al 35 and Araujo et al 43 studies because of their effect on statistical heterogeneity. A total of eight, 27,31,33,42,45,51,53,54 six, 9,23,28-30,55 eight, 13,21,22,38,39,41,45,50 nine 25,26,32,33,36,[46][47][48]52 and six 24,34,37,40,44,56 studies reported performing their imaging modality to assess LA at 0-1, >1-3, >3-6, >6-12 and >12 months after birth. respectively.…”

Section: Laterality Of La By Mode Of Birthmentioning

confidence: 99%

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Levator ani avulsion: a Systematic evidence review (LASER)

Rušavý

Paymova

Kozerovsky³

et al. 2021

BJOG

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Background There is variation in the reported incidence rates of levator avulsion (LA) and paucity of research into its risk factors. Objective To explore the incidence rate of LA by mode of birth, imaging modality, timing of diagnosis and laterality of avulsion. Search strategy We searched MEDLINE, EMBASE, CINAHL, AMED and MIDIRS with no language restriction from inception to April 2019. Study eligibility criteria A study was included if LA was assessed by an imaging modality after the first vaginal birth or caesarean section. Case series and reports were not included. Data collection and analysis RevMan v5.3 was used for the meta‐analyses and SW SAS and STATISTICA packages were used for type and timing of imaging analyses. Results We included 37 primary non‐randomised studies from 17 countries and involving 5594 women. Incidence rates of LA were 1, 15, 21, 38.5 and 52% following caesarean, spontaneous, vacuum, spatula and forceps births, respectively, with no differences by imaging modality. Odds ratio of LA following spontaneous birth versus caesarean section was 10.69. The odds ratios for LA following vacuum and forceps compared with spontaneous birth were 1.66 and 6.32, respectively. LA was more likely to occur unilaterally than bilaterally following spontaneous (P < 0.0001) and vacuum‐assisted (P = 0.0103) births but not forceps. Incidence was higher if assessment was performed in the first 4 weeks postpartum. Conclusions LA incidence rates following caesarean, spontaneous, vacuum and forceps deliveries were 1, 15, 21 and 52%, respectively. Ultrasound and magnetic resonance imaging were comparable tools for LA diagnosis. Tweetable abstract Levator avulsion incidence rates after caesarean, spontaneous, vacuum and forceps deliveries were 1, 15, 21 and 52%, respectively.

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Section: Resultsmentioning

confidence: 99%

Section: Resultsmentioning

confidence: 99%

Section: Laterality Of La By Mode Of Birthmentioning

confidence: 99%

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Levator ani avulsion: a Systematic evidence review (LASER)

Rušavý

Paymova

Kozerovsky³

et al. 2021

BJOG

View full text Add to dashboard Cite

show abstract

“…This is likely due to the smaller study size. Other risk factors shown to be associated with levator trauma include increasing maternal age , smaller AP diameter at rest and on Valsalva on transperineal ultrasound and increasing head circumference and birthweight of the newborn . However, findings have been inconsistent across studies and the clinical usefulness of these parameters is limited, especially in the case of estimated fetal weight using antenatal ultrasound.…”

Section: Discussionmentioning

confidence: 99%

Can pelvic floor trauma be predicted antenatally?

Caudwell-Hall

Atan

Brown

et al. 2018

Acta Obstet Gynecol Scand

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“…[13][14][15][16][17] Besides maternal age and pre-pregnancy body mass index (BMI), the woman's pelvic floor anatomy and antenatal pelvic floor muscle (PFM) function may influence the risk for major LAM defects. 16,[18][19][20] Prolonged second stage of labor, forceps delivery and neonatal birthweight appears to be the foremost intrapartum risk factors for acquiring major LAM defects. 5,15,21 The literature concerning the impact of vacuum delivery on major LAM defects is inconsistent.…”

Section: Introductionmentioning

confidence: 99%

Change in prevalence of major levator ani muscle defects from 6 weeks to 1 year postpartum, and maternal and obstetric risk factors: A longitudinal ultrasound study

Halle

Stær-Jensen

Hilde

et al. 2020

Acta Obstet Gynecol Scand

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Introduction The present study aimed first to investigate the change in prevalence of major levator ani muscle (LAM) defects, also called avulsions, from 6 weeks to 1 year postpartum, and second to assess maternal and obstetric risk factors for having persistent major LAM defects/avulsions at 1 year postpartum. Material and methods This is a secondary analysis of data from a prospective cohort study including 300 nulliparous women at 17‐19 weeks of gestation. Major LAM defects were diagnosed at 6 weeks and 1 year postpartum using transperineal ultrasonography. We defined persistent major LAM defects as a defect diagnosed both at 6 weeks and 1 year postpartum. Maternal and obstetric data were obtained from the hospital’s electronic birth records. Pelvic floor muscle function was measured vaginally by manometer at 21 weeks of gestation. The main outcome measurement was change in prevalence of major LAM defects. Maternal and obstetric risk factors for having persistent major LAM defect were also assessed. Results Prevalence of major LAM defects was 19.4% at 6 weeks and 10.4% at 1 year postpartum. No new major LAM defects were diagnosed at 1 year postpartum. Persisting major LAM defects were associated with longer second stage of labor (median 74.5 minutes vs median 48.0 minutes, P = .012) and higher neonatal birthweight (mean difference of 232.3 g, 95% confidence interval [CI] 21.5‐443.1). Vacuum delivery was independently associated with persistent major LAM defects, adjusted OR 3.0 (95% CI 1.0‐9.0). Conclusions There was a 50% reduction of sonographically diagnosed major LAM defects from 6 weeks to 1 year postpartum. This finding suggests that assessment of the major LAM 6 weeks postpartum may be too early to diagnose defects/avulsions. Long second stage of labor, high neonatal birthweight and vacuum delivery were associated with persistent major LAM defects/avulsions.

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Antenatal pelvic floor biometry is related to levator ani muscle injury

Cited by 3 publications

References 26 publications

Levator ani avulsion: a Systematic evidence review (LASER)

Levator ani avulsion: a Systematic evidence review (LASER)

Can pelvic floor trauma be predicted antenatally?

Change in prevalence of major levator ani muscle defects from 6 weeks to 1 year postpartum, and maternal and obstetric risk factors: A longitudinal ultrasound study

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