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Can pelvic floor trauma be predicted antenatally?
Jessica Caudwell-Hall1, Ixora Kamisan Atan1,2, Chris Brown3
1Sydney Medical School Nepean, University of Sydney, Nepean Hospital, Penrith, NSW, Australia.
Acta Obstetricia Et Gynecologica Scandinavica
|February 3, 2018
Summary
Antenatal predictors like maternal age, BMI, and bladder neck descent can indicate levator trauma during first vaginal deliveries. Identifying these factors aids in managing pelvic organ prolapse risk.
Area of Science:
- Obstetrics and Gynecology
- Pelvic Floor Disorders
- Medical Imaging
Background:
- Levator ani muscle trauma during childbirth is a significant risk factor for pelvic organ prolapse.
- Identifying antenatal predictors for levator trauma is crucial for proactive management and prevention strategies.
Purpose of the Study:
- To identify antenatal predictors associated with significant levator ani muscle damage following a first vaginal delivery.
Main Methods:
- Retrospective observational study of 1148 primiparae, with translabial ultrasound assessments antepartum and postpartum.
- Analysis of ultrasound data for levator avulsion and microtrauma in 871 women.
- Multivariate analysis to determine associations between maternal characteristics and levator trauma.
Main Results:
- Levator avulsion occurred in 98 women and microtrauma in 97.
- Increasing maternal age, lower body mass index, and lower bladder neck descent predicted levator avulsion.
- Increased bladder neck descent and a family history of cesarean section predicted microtrauma.
Conclusions:
- Maternal age, body mass index, bladder neck descent, and family history of cesarean section are significant antenatal predictors of levator trauma.
- These findings can inform risk assessment and potential interventions for pelvic organ prolapse prevention.
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