Can pelvic floor trauma be predicted antenatally?

Simple item page
dc.contributor.authorCaudwell‐Hall, Jessica
dc.contributor.authorKamisan Atan, Ixora
dc.contributor.authorBrown, Chris
dc.contributor.authorGuzmán Rojas, Rodrigo
dc.contributor.authorLanger, Susanne
dc.contributor.authorShek, Ka Lai
dc.contributor.authorDietz, Hans
dc.date.accessioned2019-07-09T13:57:46Z
dc.date.available2019-07-09T13:57:46Z
dc.date.issued2018
dc.description.abstractIntroduction: 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.
dc.description.versionVersión Publicada
dc.identifier.citationCaudwell-Hall J, Kamisan Atan I, Brown C, Guzman Rojas R, Langer S, Shek KL, et al. Can pelvic floor trauma be predicted antenatally?. Acta Obstet Gynecol Scand 2018; 97:751–757.
dc.identifier.urihttp://hdl.handle.net/11447/2512
dc.identifier.urihttps://doi.org/10.1111/aogs.13315
dc.language.isoen
dc.publisherNordic Federation of Societies of Obstetrics and Gynecology/ Wiley
dc.sourceActa Obstetricia et Gynecologica Scandinavica
dc.subjectBirth trauma
dc.subjectForceps
dc.subjectLevator avulsion
dc.subjectPelvic organ prolapse
dc.subjectPrediction
dc.subjectUltrasound
dc.titleCan pelvic floor trauma be predicted antenatally?
dc.typeArticle

Files

Original bundle
Now showing 1 - 1 of 1
Thumbnail Image
Name:
Can-pelvic-floor-trauma-be-predicted-antenatally (1).pdf
Size:
369.06 KB
Format:
Adobe Portable Document Format
Description:
Texto completo
Download

Collections

Artículos Medicina y Ciencias de la Salud

Implementado por OpenGeek Services