OC09.04: Determination of levator ani muscle lesions in instrumental delivery with vacuum using transperineal 3D–4D ultrasonography

Abstract

Oral communication abstractsultrasound data (n = 12), leaving 538 data sets for analysis. The mean age was 53 years . Prolapse symptoms were reported by 263 (49%). On PFUS mean bladder descent was −6.5mm (32 to −63.8), mean uterine descent +14.3mm (56.1 to −51.1), mean enterocele descent −0.92mm (0 to −48.6) and mean rectal descent was −7.26mm (39 to −54.1). ROC statistics suggested a cut-off 15mm above the symphysis pubis for diagnosing an abnormal degree of uterine descent on Valsalva, giving a sensitivity of 70% and a specificity of 57% for the prediction of symptoms of prolapse. The area under the curve was 0.68 (0.63−0.72). Conclusions:In this large retrospective study, the optimal cut-off for defining abnormal descent of the uterus was defined as 15 mm above the SP. This is much more cranial than previously defined cutoffs for bladder prolapse (10 mm below the SP) and rectal descent (15 mm below the SP). Clearly, a given degree of uterine descent is much more likely to lead to symptoms of prolapse than the same degree of bladder or rectal descent. OC09.04Determination of levator ani muscle lesions in instrumental delivery with vacuum using transperineal 3D-4D ultrasonography