Related Experiment Video
Updated: Jun 9, 2026
07:41
Quantification of Levator Ani Hiatus Enlargement by Magnetic Resonance Imaging in Males and Females with Pelvic Organ Prolapse
Published on: April 17, 2019
Intrapartum risk factors for levator trauma
1Nepean Clinical School, University of Sydney, Nepean Hospital, Sydney, NSW 2750, Australia. shekkalai@yahoo.com.hk
BJOG : an International Journal of Obstetrics and Gynaecology
|August 26, 2010
Summary
First-time delivery levator trauma is linked to forceps, longer second stage labor, and vaginal birth. Epidural anesthesia may offer protection against this birth trauma.
Area of Science:
- Obstetrics and Gynecology
- Pelvic Floor Disorders
- Medical Imaging
Background:
- Levator trauma, including avulsion and overdistension, is a significant concern following childbirth.
- Identifying intrapartum risk factors is crucial for preventing long-term pelvic floor dysfunction.
Purpose of the Study:
- To investigate intrapartum risk factors associated with levator trauma.
- To utilize ultrasound imaging for the identification of levator trauma in nulliparous women.
Main Methods:
- Prospective observational study involving 488 nulliparous women.
- Four-dimensional translabial ultrasound performed antenatally and 3-4 months postpartum.
- Collection of obstetric data and assessment for levator avulsion and irreversible overdistension.
Main Results:
- Levator avulsion occurred in 13% of women with vaginal delivery; none in the cesarean group.
- Forceps delivery (OR 3.83) and longer second stage of labor (OR 1.01 per minute) were significantly associated with avulsion.
- Epidural analgesia showed a protective effect (OR 0.42) against levator trauma.
Conclusions:
- Vaginal delivery, particularly with forceps and prolonged second stage, increases the risk of levator trauma.
- Epidural pain relief may mitigate the risk of levator trauma during childbirth.
Related Concept Videos
01:26Factors Affecting the Risk of Infection
The hosts' susceptibility to infection depends on several factors. The integrity of the skin and mucous membranes helps protect the body against microbial attacks. When the skin is altered, the chance of infection, limb loss, and even death increases.
The integrity and count of the white blood cells help the body resist pathogens and fight infection. When impaired, it reduces the body's resistance to pathogens. The acidic pH levels of the gastrointestinal, genitourinary tracts, and skin create...
The integrity and count of the white blood cells help the body resist pathogens and fight infection. When impaired, it reduces the body's resistance to pathogens. The acidic pH levels of the gastrointestinal, genitourinary tracts, and skin create...
01:22Esophageal Perforation-I: Introduction
Esophageal perforation is a severe medical condition characterized by a breach in the integrity of the esophageal wall. This breach can occur due to various factors such as trauma, medical procedures, or underlying diseases. When the esophageal wall is compromised, it allows food, fluids, and digestive juices into the chest cavity or adjacent structures, leading to potential complications and health risks.
The location of esophageal perforation can vary, occurring anywhere along the esophagus.
The location of esophageal perforation can vary, occurring anywhere along the esophagus.
01:28Development of the Oral Microbiota
The establishment of the oral microbiome begins before birth, challenging the long-held belief that the fetal oral cavity is sterile. The presence of oral microbes such as Streptococcus and Fusobacterium in amniotic fluid suggests that microbial exposure may occur in utero, potentially through translocation from the maternal oral or gastrointestinal tract. This early colonization primes the neonatal immune system and sets the stage for subsequent microbial succession. Maternal health,...