How common is pelvic floor muscle atrophy after vaginal childbirth?

Dixit, Priyanka; Shek, Ka Lai; Dietz, Hans Peter

doi:10.1002/uog.12543

Cited by 7 publications

(7 citation statements)

References 37 publications

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“…Vaginal delivery is correlated with a higher rate of levator ani muscle (LAM) injury, enlargement of the hiatal area, increased bladder neck mobility, and puborectalis defects (19). During vaginal delivery, the levator ani expands by 2.5% to 24.5% to facilitate the widening of the levator hiatus during crowning (20,21). Cases of POP have been reported to arise from injury to the levator ani muscle (22,23).…”

Section: Discussionmentioning

confidence: 99%

Short-term effects of delivery methods on postpartum pelvic floor function in primiparas: a retrospective study

Zhang

Wang

et al. 2021

Ann Palliat Med

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Background: The present study sought to investigate the short-term effects of different delivery methods on postpartum pelvic floor function in Chinese primiparas. Methods: Primiparous women who delivered a full-term, cephalic, singleton infant at our hospital between January 1, 2018 and August 15, 2019 were recruited into this study. All women underwent pelvic floor function screening at 6-8 weeks postpartum. Tests included postpartum Pelvic Organ Prolapse Quantification (POP-Q) score, incidence of urinary incontinence, pelvic floor muscle (PFM) strength, and Pelvic Floor Distress Inventory Questionnaire-Short Form 20 (PFDI-20) score.Results: A total of 284 postpartum women were recruited into the study. Of the participants, 147 had undergone vaginal delivery, 37 had undergone intrapartum cesarean delivery (ICD), and 100 had undergone elective cesarean delivery (ECD). Points Aa, Ba, Ap, and Bp showed a greater degree of prolapse in the vaginal delivery group than in the ECD group (P≤0.05). UI was less prevalent in ECD group relative to the vaginal delivery group (P≤0.05). Tonic PFM contraction was weaker in the vaginal delivery group than in the ECD and ICD groups (P≤0.05). Significant differences were also observed between the vaginal delivery group and the ECD group with respect to PFDI-20 scores (P≤0.05).Conclusions: Compared with vaginal delivery, ECD was strongly linked to a lower risk of pelvic organ prolapse (POP) and UI, stronger tonic PFM strength, and lower PFDI-20 scores. ECD confers relatively better protection against pelvic floor dysfunction (PFD) than does ICD.

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Section: Discussionmentioning

confidence: 99%

Short-term effects of delivery methods on postpartum pelvic floor function in primiparas: a retrospective study

Zhang

Wang

et al. 2021

Ann Palliat Med

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“…The distances from the symphysis pubis (right angle to the reference line through the pubic symphysis) of the bladder neck, cervix, and anorectal junction at rest and on Valsalva maneuver were recorded (Figure 1 ). 17 , 23 , 24 …”

Section: Methodsmentioning

confidence: 99%

Longitudinal Study of Pelvic Floor Characteristics Before, During, and After Pregnancy in Nulliparous Women

Lakovschek

Trutnovsky

Obermayer–Pietsch

et al. 2021

J of Ultrasound Medicine

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Objectives To investigate the changes in the pelvic floor before, during, and after pregnancy in the same collective of nulliparous women. Methods In a prospective observational pilot study between April 2015 and June 2019 in nulliparous women with planned pregnancy, we used the pelvic organ prolapse quantification (POP‐Q) system; a 2‐dimensional (2D) sonography to investigate the bladder neck, cervix, and anorectal junction positions; and a 3D/4D sonography to measure the hiatus of the levator ani muscle (LH area) during Valsalva maneuver. Five visits were planned: 1 before, 3 during, and 1 visit after pregnancy. Results Twenty‐four women participated in the study. We achieved a minimum of 2 visit measurements from 10 women who became pregnant. The LH area decreased during the first trimester and then increased until the third trimester. Postpartum, the LH area reached the prepregnancy state. We observed changes in the bladder neck mobility, bladder neck position, cervix, and anorectal junction from the first trimester. Postpartum, the bladder neck mobility was higher, and the position of the bladder neck and anorectal junction was lower than before pregnancy. We observed no remarkable changes in the POP‐Q state during pregnancy. Conclusion This was the first study to investigate pelvic floor characteristics in the same collective before, during, and after pregnancy. We observed pelvic floor changes from the prepregnancy state to the first trimester to postpartum. The study results need to be confirmed in a larger study.

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“…The set of muscles located in the PF is collectively called the levator ani muscles (LAM). During vaginal delivery, LAM is extended by approximately 245%, allowing the levator hiatus (LH) to widen during crowning (DeLancey et al 2007;Shek and Dietz 2010;Tubaro et al 2011;Dixit et al 2014;Dieter et al 2015). Vaginal delivery is associated with multiple LAM defects, all of which are risk factors for later-life pelvic floor dysfunction (PFD) (Dalpiaz and Curti 2006;Shek and Dietz 2010;Tubaro et al 2011;Dixit et al 2014;Dieter et al 2015;Notten et al 2017;de Araujo et al 2018).…”

Section: Introductionmentioning

confidence: 99%

“…During vaginal delivery, LAM is extended by approximately 245%, allowing the levator hiatus (LH) to widen during crowning (DeLancey et al 2007;Shek and Dietz 2010;Tubaro et al 2011;Dixit et al 2014;Dieter et al 2015). Vaginal delivery is associated with multiple LAM defects, all of which are risk factors for later-life pelvic floor dysfunction (PFD) (Dalpiaz and Curti 2006;Shek and Dietz 2010;Tubaro et al 2011;Dixit et al 2014;Dieter et al 2015;Notten et al 2017;de Araujo et al 2018). PFD comprises disorders that include stress urinary incontinence (SUI), overactive bladder and pelvic organ prolapse (POP) (Bedretdinova et al 2016;de Araujo et al 2018).…”

Section: Introductionmentioning

confidence: 99%

“…Strain imaging can be performed using both MRI and US. However, 3D US imaging has several benefits with respect to MRI, for example, its ease of use, portability, minimal discomfort, relatively short period required for acquisition of the data and low price (Shek and Dietz 2010;Tubaro et al 2011;Shek and Dietz 2013;Dixit et al 2014;Dieter et al 2015). Furthermore, good consistency between US and MRI in the imaging of PF muscles has been established (Yan et al 2017).…”

Section: Introductionmentioning

confidence: 99%

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3D Ultrasound Strain Imaging of Puborectalis Muscle

Das¹,

Hansen²,

Hendriks³

et al. 2021

Ultrasound in Medicine & Biology

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The female pelvic floor (PF) muscles provide support to the pelvic organs. During delivery, some of these muscles have to stretch up to three times their original length to allow passage of the baby, leading frequently to damage and consequently later-life PF dysfunction (PFD). Three-dimensional (3D) ultrasound (US) imaging can be used to image these muscles and to diagnose the damage by assessing quantitative, geometric and functional information of the muscles through strain imaging. In this study we developed 3D US strain imaging of the PF muscles and explored its application to the puborectalis muscle (PRM), which is one of the major PF muscles.

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How common is pelvic floor muscle atrophy after vaginal childbirth?

Abstract: ABSTRACT

Cited by 7 publications

References 37 publications

Short-term effects of delivery methods on postpartum pelvic floor function in primiparas: a retrospective study

Short-term effects of delivery methods on postpartum pelvic floor function in primiparas: a retrospective study

Longitudinal Study of Pelvic Floor Characteristics Before, During, and After Pregnancy in Nulliparous Women

3D Ultrasound Strain Imaging of Puborectalis Muscle

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