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Updated: May 29, 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
Does childbirth alter the reflex pelvic floor response to coughing?
Summary
Childbirth alters pelvic floor reflexes, reducing their strength postpartum. This change, potentially linked to vaginal delivery, may be associated with postpartum stress urinary incontinence in women.
Area of Science:
- Obstetrics and Gynecology
- Pelvic Floor Imaging
- Female Pelvic Medicine
Background:
- Pelvic floor muscle function is crucial for continence.
- Childbirth can impact pelvic floor integrity and function.
- Understanding peripartal changes in pelvic floor reflexes is important for managing postpartum conditions.
Purpose of the Study:
- To determine the prevalence of pelvic floor reflex activation during coughing in nulliparous pregnant women.
- To quantify the effect of childbirth on pelvic floor reflex strength.
- To assess peripartal changes in pelvic floor reflexes and their association with stress urinary incontinence.
Main Methods:
- 131 nulliparous pregnant women underwent four-dimensional translabial ultrasound.
- Pelvic floor ultrasound datasets during coughs were analyzed.
- Midsagittal hiatal diameter changes quantified reflex levator contraction magnitude.
Main Results:
- A visible pelvic floor reflex was present in 98% of women antepartum.
- Postpartum, reflex prevalence decreased to 75% (P < 0.001).
- Reflex contraction magnitude significantly reduced postpartum (4.8 mm to 2.0 mm, P < 0.001), associated with delivery mode.
Conclusions:
- Childbirth significantly alters pelvic floor reflex magnitude and prevalence.
- Vaginal delivery may be associated with these alterations.
- Reduced reflex magnitude shows a trend towards association with postpartum stress urinary incontinence.
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