Evaluation of Levator ani muscle injury in primiparous women at one and six weeks’ post-partum using 3D transperineal ultrasound: comparative Cohort study

Abstract

Background. Vaginal birth is known to be the main etiological factor for development of levator ani defects. Transperineal ultrasonography has been used exten-sively for pelvic floor assessment with minimal discomfort to the patient and low-er cost. The aim is to define and evaluate changes in the levator ani muscle in the first week and at 6 weeks after delivery with 3D Transperineal ultrasonography. Patients and Methods. Retrospective study of 355 eligible primiparous women who delivered vaginally and had been examined within the first week and 6 weeks after delivery with 3D transperineal ultrasonography. Results. Women showed a significantly larger hiatal area at rest and on Valsalva, 6 weeks post-partum, LAM avulsions decreased at 6 weeks to be 13.2%. Conclusions. First vaginal delivery led to persistent hiatal area enlargement. Le-vator ani muscle avulsions can be diagnosed easily by 3D ultrasound, and they are not the only cause of stress urinary incontinence after vaginal delivery.