Evaluation of labor-related pelvic floor changes 3 months after delivery: a 3D transperineal ultrasound study

Aydın, Serdar; Aydın, Çağrı Arıoğlu

doi:10.1007/s00192-015-2774-x

Cited by 7 publications

(13 citation statements)

References 32 publications

(46 reference statements)

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“…This may be because postpartum MRI examinations are mostly performed at a later time . However, due to the proven relation of levator trauma, vaginal delivery, and increased risk of pelvic organ prolapse early postpartum pelvic floor evaluation is performed with certain frequency using ultrasound . This seems beneficial compared to later evaluation regarding early detection of defects and the possibility for preventive measures .…”

Section: Discussionmentioning

confidence: 99%

“…Vaginal childbirth is a known risk factor for levator muscle trauma, which has substantial implications for pelvic organ support and is strongly associated with female pelvic organ prolapse . Early detection of defects of the levator muscle and subsequent early intervention may delay the clinical effects of labor‐related changes in the pelvic floor . Therefore, it seems appropriate to examine the pelvic floor in an early postnatal period as it may be important for preventive measures …”

Section: Introductionmentioning

confidence: 99%

“…Early detection of defects of the levator muscle and subsequent early intervention may delay the clinical effects of labor‐related changes in the pelvic floor . Therefore, it seems appropriate to examine the pelvic floor in an early postnatal period as it may be important for preventive measures …”

Section: Introductionmentioning

confidence: 99%

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Early postpartum pelvic floor changes in primiparous women after vaginal delivery using 3T MRI

Alt

Hampel

Radtke

et al. 2017

Neurourology and Urodynamics

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AIMS Detection of early morphological pelvic floor changes after vaginal delivery in primiparous women using 3 Tesla magnetic resonance imaging. METHODS A 3 Tesla magnetic resonance imaging was performed using static T2‐weighted turbo spin echo (tse) in three planes, T2‐weighted tse fat saturated and T1‐weighted sequence in transverse plane. All visible changes of pelvic structures (edema, hematoma, tear, or avulsion) were documented. Measurements for the integrity of the pelvic floor were performed and compared to a nulliparous control‐group. Differences in pelvic floor parameters were analyzed using an unpaired t‐test. P<0.05 was considered statistically significant. RESULTS Twenty‐five primiparous women delivered vaginally at term and underwent postpartum magnetic resonance imaging. Several morphological changes in the pelvis, superficial as well as deep, were detected in all participants. Anteroposterior hiatus, hiatal circumference, hiatal area, laterolateral hiatus, maximum muscle thickness, and levator urethra gap were significantly different to the nulliparous control‐group. CONCLUSIONS Two‐dimensional 3 Tesla magnetic resonance imaging is feasible in a clinical and early postpartum setting establishing a reliable diagnostic tool to evaluate numerous morphological pelvic floor changes and the integrity of the pelvic floor.

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Section: Discussionmentioning

confidence: 99%

Section: Introductionmentioning

confidence: 99%

See 1 more Smart Citation

Early postpartum pelvic floor changes in primiparous women after vaginal delivery using 3T MRI

Alt

Hampel

Radtke

et al. 2017

Neurourology and Urodynamics

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“…We identified 23 studies involving a total of 2152 women that assessed LA following the first spontaneous vaginal birth. 9,21,24,28,29,[31][32][33][34]37,39,41,[43][44][45][46][47][48][50][51][52][53]55 The pooled incidence rate of LA in these studies was 0.16 (16%) (0.13-0.19, I 2 = 73%). The highest incidence rate of LA of 0.58 (58%) was reported by Araujo et al, 43 which was much higher than the rates reported by other studies.…”

Section: Levator Avulsion and First Spontaneous Vaginal Deliverymentioning

confidence: 99%

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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“…Analysis of the reasons shows that LHLR, LHAP, LHA, the left and right LAT are the main morphological features of the levator ani muscle and pelvic diaphragm hiatus, which can fully reflect the changes in the pelvic floor structure of the patient. During vaginal delivery, the fetus is delivered through the pelvic diaphragm hiatus, which causes excessive stretching and expansion of the pelvic floor muscles, which destroys the integrity of the pelvic diaphragm hiatus, showing large LHLR, LHAP, and LHA [9][10][11]. In addition, due to the damage of the pelvic floor muscles, the body's defensive repair and reflex, the left and right LAT increases.…”

Section: Discussionmentioning

confidence: 99%

The diagnostic value of four-dimensional ultrasound examination of perineum in the diagnosis of postpartum pelvic floor dysfunction

et al. 2021

E3S Web Conf.

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Objective to explore the diagnostic value of perineal four-dimensional ultrasound (4D-US) in postpartum pelvic floor dysfunction (PFD) disease. 328 postpartum PFD patients diagnosed by clinical pelvic floor palpation from June 2018 to December 2020 were selected as the PFD group, and 328 patients without PFD were selected as the control group. All participants underwent perineal 4D-US, the indicators were statistically analyzed. The results showed that the LAT of left and right, LHLR, LHAP, LHA, resting state and holding the breath in the PFD group were higher than those in the control group, and the difference was statistically significant (P<0.05). From cervix to lower margin of pubic symphysis, bladder to lower margin of pubic symphysis of the pubic symphysis, and from the ampulla of the rectum to the lower margin of the pubic symphysis, the PFD group was larger than the control group, but the result of urethral rotation was reversed, and the difference was statistically significant (P<0.05). The morphologic features of the levator ani muscle and pelvic fissure can be detected early using 4D-US, which is a reliable technique that can be learned in a short period of time.

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Evaluation of labor-related pelvic floor changes 3 months after delivery: a 3D transperineal ultrasound study

Cited by 7 publications

References 32 publications

Early postpartum pelvic floor changes in primiparous women after vaginal delivery using 3T MRI

Early postpartum pelvic floor changes in primiparous women after vaginal delivery using 3T MRI

Levator ani avulsion: a Systematic evidence review (LASER)

The diagnostic value of four-dimensional ultrasound examination of perineum in the diagnosis of postpartum pelvic floor dysfunction

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