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

Roughly three million women in the United States give birth vaginally each year [1]. Clinically, the vagina undergoes pronounced adaptations up to the time of delivery, presumably to afford passage of the fetus [2]. Our group has suggested that if these adaptations are not sufficient or if fetus size is too large, an injury to the vagina or its supportive tissues will likely result. Vaginal injury at the time of delivery occurs quite frequently and research examining the levator ani muscle, the major muscular component of the pelvic floor, revealed injury in up to 20% of women who have given birth vaginally [3]. Therefore, vaginal birth is considered one of the greatest risk factors for pelvic floor disorders (i.e. urinary dysfunction and pelvic organ prolapse) later in life.

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OP18.07: Clinical effects and risk factors for levator ani muscle damage in primiparas

Ultrasound in Obstetrics and Gynecology ◽

10.1002/uog.12877 ◽

2013 ◽

Vol 42 (s1) ◽

pp. 100-100

Author(s):

M. Lipschuetz ◽

S. M. Cohen ◽

D. V. Valsky ◽

L. Shick-Naveh ◽

B. Messing ◽

...

Keyword(s):

Risk Factors ◽

Muscle Damage ◽

Levator Ani ◽

Levator Ani Muscle ◽

Clinical Effects

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Avulsion of the Levator Ani at First Pregnancy

Indonesian Journal of Obstetrics and Gynecology ◽

10.32771/inajog.v37i1.338 ◽

2016 ◽

Author(s):

Denny Khusen

Keyword(s):

Risk Factors ◽

Levator Ani ◽

Levator Ani Muscle ◽

Translabial Ultrasound ◽

Digital Assessment ◽

Nulliparous Women ◽

4D Ultrasound ◽

Levator Trauma ◽

Levator Ani Avulsion

Objective: To investigate whether demographic and obstetric risk factors are associated with avulsion of the levator ani at first pregnancy. Methods: A series of case was undertaken on 4 pregnant nulliparous women seen with a gestational age of more than 37 weeks. We analyzed with 3D/4D translabial ultrasound and digital assessment data of 4 women seen in a tertiary Urogynecological clinic. The use of 3D/4D ultrasound as a means of detection of trauma to the levator ani. Result: We had 4 women who had levator ani avulsion. Diagnosis of levator trauma (avulsion) on tomographic ultrasound was correlated with predelivery demographic variables and ultrasound parameters. Conclusion: With a greater understanding on the function of pelvic floor muscles, risk factors for trauma and damage as a result of pregnancy and birth, healthcare professionals will have better ability to meet the needs of women in the childbearing year. This study utilized a scoring system that can be used to predict the occurrence of levator ani muscle damage. In the end, the decline in quality of life for women, especially after a birth, can be prevented. [Indones J Obstet Gynecol 2013; 37-1: 51-6] Keywords: 3D/4D translabial ultrasound, demographic, levator ani avulsion, obstetric risk factors

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