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A review of levator ani avulsion after childbirth: Incidence, imaging and management

Elizabeth Doxford-Hook1, Candice Downey2, Joanna Gibson1

  • 1ST7 O&G Registrar. Leeds Teaching Hospital Trust, St James's University Hospital, Beckett Street, Leeds, UK.

Midwifery
|October 3, 2022
PubMed

Key Content • Levator ani muscle (LAM) avulsion injury occurs occultly during childbirth, most commonly during operative vaginal deliveries. • Injuries of levator ani have long term sequelae for pelvic floor health. As life expectancy increases the burden of disease upon urogynaecology services will need to be considered. • Diagnosis of this condition can be difficult as there is no agreed 'gold standard' imaging modality. • There is no consensus regarding surgical management of LAM avulsion. Learning objectives • Review anatomy and function of levator ani muscle • Identify the risk factors for levator ani avulsion injury • Role of imaging to appropriately identify LAM injury and current management options including appropriate follow up • Management of subsequent pregnancy following LAM avulsion Ethical issues • Is there value to the patient in diagnosing levator ani avulsion when there is no recommended treatment for these injuries?

Keywords:
Levator ani muscleLevator ani muscle avulsionPelvic organ prolapse, Urogynaecology

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