Racial differences in pelvic morphology among asymptomatic nulliparous women as seen on three-dimensional magnetic resonance images

Hoyte, Lennox; Thomas, John V.; Foster, Raymond T.; Shott, Susan; Jakab, Marianna; Weidner, Alison C.

doi:10.1016/j.ajog.2005.06.060

Cited by 66 publications

(37 citation statements)

References 19 publications

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“…The maximal force potential of a muscle is proportional to the sum of the crosssectional areas of all the fibres, therefore the thicker the muscle, the greater the force potential [20]. With MRI studies, Duong and Korn [21] found that the PFM in nulliparous black women are thicker than in white women, which also confirm the results of two other morphological studies [22,23]. Hence, it is expected that black women would have stronger PFM than white women.…”

Section: Discussionsupporting

confidence: 77%

Ethnic differences in pelvic floor muscle strength and endurance in South African women

et al. 2014

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Section: Discussionsupporting

confidence: 77%

Ethnic differences in pelvic floor muscle strength and endurance in South African women

et al. 2014

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“…Abnormal muscle can be identified by a change in the thickness or topography of the muscle. However, normal pelvic floor morphology can vary significantly in women of different race [7] and age [8]. The present study evaluated changes in levator ani abnormalities on pelvic MRI 6 weeks and 6 months after a first obstetrical delivery and correlated these findings with demographic data and mode of delivery.…”

Section: Introductionmentioning

confidence: 99%

Levator ani abnormality 6 weeks after delivery persists at 6 months

Branham

Thomas

Jaffe

et al. 2007

American Journal of Obstetrics and Gynecology

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Objective: Assess post partum changes in the levator ani muscle using magnetic resonance (MR) imaging and relate these changes to obstetrical events and risk factors associated with pelvic floor dysfunction.Study Design: A board certified radiologist specializing in abdominal imaging evaluated 146 pelvic MR studies from 57 primiparas 6 weeks and 6 months after first obstetrical delivery and 32 nulliparas. A yes/no determination of muscle body and insertion integrity, muscle thinning, and measurement of muscle thickness in mm was made for each of four muscle sites: right and left puborectalis, right and left ileococcygeous.Incidence of muscle abnormality and mean muscle thickness were tested in pairs between 1) nulliparas and 6 week primiparas, 2) 6 week and 6 month primipara pairs, and 3) three age/race groups using test of two proportions and one-way anova.Results: Initial review indicated only 3 subjects not of African-American (AA) or Caucasian (W) race, and only 1 AA primipara of age ≥30yrs, therefore statistical analysis was limited to 45 primiparas and 25 nulliparas. Incidence of any abnormality at any of the 4 sites was considered abnormal. Frequency of abnormal muscle by race and age is shown in the In those subjects recovering to normal MR by 6 months, an average of nearly 60% increase in R puborectalis muscle thickness compared to that seen at 6 weeks indicated the extent of the injury. Subjects with injury to both the puborectalis and ileococcygeous at 6 weeks did not recover to normal at 6 months, whereas those with injury only to the puborectalis tended to have normal MR at 6 months. Publisher's Disclaimer: This is a PDF file of an unedited manuscript that has been accepted for publication. As a service to our customers we are providing this early version of the manuscript. The manuscript will undergo copyediting, typesetting, and review of the resulting proof before it is published in its final citable form. Please note that during the production process errors may be discovered which could affect the content, and all legal disclaimers that apply to the journal pertain. NIH Public AccessAuthor Manuscript Conclusions: Nulliparity did not guarantee a normal assessment of levator ani anatomy by our blinded reader, and frequency of injury in this series is somewhat greater than that previously reported for primiparas. Younger Caucasian primiparas had a better recovery at 6 months than older Caucasians. Subjects experiencing more global injury, in particular to the ileococcygeous, tended not to recover muscle bulk.

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“…We included ethnic origin as a study parameter, as thicker levator ani muscles [16], smaller total pelvic floor area [17], closer puborectalis attachment [18] and smaller sacral angulation with larger lumbosacral curvature [19] have been reported in Afro-Caribbean compared to White women. Such pelvic musculoskeletal anatomical differences might have some biomechanical bearing on the positioning and motility of the uterus and cervix within the pelvis.…”

Section: Discussionmentioning

confidence: 99%

Predictors of acute cervicouterine angulation in patients scheduled for gynaecological or infertility intrauterine office procedures

Abdel-Gadir¹,

Oyawoye

Chander³

2009

Gynecol Surg

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The purpose behind this observational study was to find whether age, parity, ethnicity, uterine position or the mode of presentation (infertility or gynaecological) could be used to predict acute cervicouterine angulation (ACUA) before intrauterine office surgical procedures. Uterine version, flexion and ACUA were recorded after transvaginal scanning in 914 patients and during subsequent examinations in a subgroup of 422 patients. ACUA was tested against presentation, age, parity, ethnicity and uterine position using chi-square and logistic regression. A two-tailed p value <0.05 was considered significant. One hundred and forty-two of 667 nulliparous (21.30%) and 23 of 247 (9.3%) parous women showed ACUA (p< 0.001), which persisted during repeated examinations. More patients with anteflexed (153/767, 19.9%) than retroflexed uteri (12/147, 8.2%) had ACUA p<0.001. It was more common in Afro-Caribbean (39/179, 21.8%) and Middle East women (37/129, 28.7%) than Caucasians (89/606, 14.7%; p=0.001). Age and presentation were not significant. Accordingly, ACUA should be considered before office intrauterine surgical procedures in nulliparous patients, especially those with anteflexed uteri. We debate the clinical implications of ethnicity.

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Racial differences in pelvic morphology among asymptomatic nulliparous women as seen on three-dimensional magnetic resonance images

Cited by 66 publications

References 19 publications

Ethnic differences in pelvic floor muscle strength and endurance in South African women

Ethnic differences in pelvic floor muscle strength and endurance in South African women

Levator ani abnormality 6 weeks after delivery persists at 6 months

Predictors of acute cervicouterine angulation in patients scheduled for gynaecological or infertility intrauterine office procedures

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