Levator Trauma After Vaginal Delivery
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- 1 October 2005
- journal article
- research article
- Published by Ovid Technologies (Wolters Kluwer Health) in Obstetrics & Gynecology
- Vol. 106 (4), 707-712
- https://doi.org/10.1097/01.aog.0000178779.62181.01
Abstract
OBJECTIVE: To date, the evidence on pelvic floor injury in labor remains sketchy due to a lack of prospective studies comparing pelvic floor imaging before and after childbirth. We intended to define the incidence of major trauma to the pubovisceral muscle. METHODS: A total of 61 nulliparous women were seen at 36–40 weeks of gestation in a prospective observational study. The assessment included an interview and 3-dimensional translabial ultrasound and was repeated 2–6 months postpartum. RESULTS: Fifty women (82%) were seen postpartum. Of the 39 women delivered vaginally, levator avulsion was diagnosed in 14 (36%, 95% confidence interval 21–51%). Among those delivered vaginally, there were associations with higher maternal age (P = .10), vaginal operative delivery (P = .07), and worsened stress incontinence postpartum (P = .02). CONCLUSIONS: Avulsion of the inferomedial aspects of the levator ani from the pelvic sidewall occurred in approximately one third of all women delivered vaginally and was associated with stress incontinence 3 months after childbirth. LEVEL OF EVIDENCE: II-3Keywords
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