Xue-Mei Wang1, Xin Chang2, Yan Ding3, Su-Zhen Wang3, Yin Zhen2, Jing-Xin Ding3, Fan-Bin Kong4. 1. Department of Ultrasound, Obstetrics and Gynecology Hospital of Fudan University, Shanghai, China. 2. Huai'an First People's Hospital, Nanjing Medical University, Jiangsu, China. 3. Department of Gynecology, Obstetrics and Gynecology Hospital of Fudan University, Shanghai, China. 4. Department of Ultrasound, Obstetrics and Gynecology Hospital of Fudan University, Shanghai, China. fanbin_kong1969@163.com.
Abstract
PURPOSE: This study utilized translabial three-dimensional ultrasound to investigate the morphological characteristics of the levator hiatus and provide sonographic evidence for assessing pelvic floor dysfunction in postpartum women. METHODS: Two-hundred and one singleton primiparae without any complications underwent translabial three-dimensional ultrasound at 6 and 18 weeks after delivery, with 12 participants lost to follow-up at 18 weeks. Fifty nulliparae were enrolled as the control group. Levator hiatal morphology at rest and on Valsalva maneuver was assessed by experienced sonographers, specifically evaluating the anteroposterior diameter, left-to-right diameter, and area. RESULTS: In postpartum women at 6 weeks after delivery, all the levator hiatal parameters were significantly higher compared with those of the control group. At 18 weeks, the hiatal parameters were better than at 6 weeks but still higher than in the nulliparous controls. In all three groups, the hiatal parameters were significantly higher during the Valsalva maneuver than at rest. CONCLUSIONS: Postpartum women are prone to develop pelvic floor dysfunction as shown by an enlarged levator hiatus. Translabial three-dimensional ultrasound can be used to effectively assess the morphology and structural alterations of the levator hiatus in postpartum women, providing reliable pelvic floor imaging for early screening, diagnosis, and prevention of pelvic floor dysfunction.
PURPOSE: This study utilized translabial three-dimensional ultrasound to investigate the morphological characteristics of the levator hiatus and provide sonographic evidence for assessing pelvic floor dysfunction in postpartum women. METHODS: Two-hundred and one singleton primiparae without any complications underwent translabial three-dimensional ultrasound at 6 and 18 weeks after delivery, with 12 participants lost to follow-up at 18 weeks. Fifty nulliparae were enrolled as the control group. Levator hiatal morphology at rest and on Valsalva maneuver was assessed by experienced sonographers, specifically evaluating the anteroposterior diameter, left-to-right diameter, and area. RESULTS: In postpartum women at 6 weeks after delivery, all the levator hiatal parameters were significantly higher compared with those of the control group. At 18 weeks, the hiatal parameters were better than at 6 weeks but still higher than in the nulliparous controls. In all three groups, the hiatal parameters were significantly higher during the Valsalva maneuver than at rest. CONCLUSIONS: Postpartum women are prone to develop pelvic floor dysfunction as shown by an enlarged levator hiatus. Translabial three-dimensional ultrasound can be used to effectively assess the morphology and structural alterations of the levator hiatus in postpartum women, providing reliable pelvic floor imaging for early screening, diagnosis, and prevention of pelvic floor dysfunction.
Authors: Jun Zhang; Helain J Landy; D Ware Branch; Ronald Burkman; Shoshana Haberman; Kimberly D Gregory; Christos G Hatjis; Mildred M Ramirez; Jennifer L Bailit; Victor H Gonzalez-Quintero; Judith U Hibbard; Matthew K Hoffman; Michelle Kominiarek; Lee A Learman; Paul Van Veldhuisen; James Troendle; Uma M Reddy Journal: Obstet Gynecol Date: 2010-12 Impact factor: 7.661