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Can pelvic floor trauma be predicted antenatally?

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dc.contributor.author Caudwell‐Hall, Jessica
dc.contributor.author Kamisan Atan, Ixora
dc.contributor.author Brown, Chris
dc.contributor.author Guzman, Rodrigo
dc.contributor.author Langer, Susanne
dc.contributor.author Shek, Ka Lai
dc.contributor.author Dietz, Hans
dc.date.accessioned 2019-07-09T13:57:46Z
dc.date.available 2019-07-09T13:57:46Z
dc.date.issued 2018
dc.identifier.citation Acta Obstet Gynecol Scand. 2018;97(6):751-757. doi: 10.1111/aogs.13315. es
dc.identifier.uri doi: 10.1111/aogs.13315. es
dc.identifier.uri http://hdl.handle.net/11447/2512
dc.description.abstract Introduction: Levator trauma is a risk factor for the development of pelvic organ prolapse. We aimed to identify antenatal predictors for significant damage to the levator ani muscle during a first vaginal delivery. Material and Methods: A retrospective observational study utilizing data from two studies with identical inclusion criteria and assessment protocols between 2005 and 2014. A total of 1148 primiparae with an uncomplicated singleton pregnancy were recruited and assessed with translabial ultrasound at 36 weeks antepartum and 871 (76%) returned for reassessment 3-6 months postpartum. The ultrasound data of vaginally parous women were analyzed for levator avulsion and microtrauma. The former was diagnosed if the muscle insertion at the inferior pubic ramus in the plane of minimal hiatal dimensions and within 5 mm above were abnormal on tomographic ultrasound imaging. Microtrauma was diagnosed in women with an intact levator and if there was a postpartum increase in hiatal area on Valsalva by >20% with the resultant area ≥25 cm2 Results: The complete datasets of 844 women were analyzed. Among them, 609 delivered vaginally: by normal vaginal delivery in 452 (54%), a vacuum birth in 102 (12%) and a forceps delivery in 55 (6%). Levator avulsion was diagnosed in 98 and microtrauma in 97. On multivariate analysis, increasing maternal age, lower body mass index and lower bladder neck descent were associated with avulsion. Increased bladder neck descent and a family history of cesarean section (CS) were associcated with microtrauma. Conclusions: Maternal age, body mass index, bladder neck descent and family history of CS are antenatal predictors for levator traum. es
dc.language.iso en es
dc.publisher Nordic Federation of Societies of Obstetrics and Gynecology/ Wiley es
dc.subject Birth trauma es
dc.subject Forceps es
dc.subject Levator avulsion es
dc.subject Pelvic organ prolapse es
dc.subject Prediction es
dc.subject Ultrasound es
dc.title Can pelvic floor trauma be predicted antenatally? es
dc.type Article es


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