Assessing Postpartum Levator Ani Muscle Recovery: A Feasibility Study on Automated Texture Analysis in Transvaginal...

Area of Science:

• Obstetrics and Gynecology
• Medical Imaging
• Musculoskeletal Ultrasound

Background:

• Levator ani (LA) muscle injury from childbirth contributes to pelvic floor disorders (PFDs).
• Understanding LA muscle healing is vital for recovery plans and prevention.
• Current evaluation methods (palpation, force measurement) are subjective and limited.

Purpose of the Study:

• To assess the feasibility of 3-D transvaginal ultrasound (US) with texture analysis for evaluating deep LA muscle injuries.
• To monitor microstructural tissue changes during postpartum healing.
• To provide objective metrics for LA muscle recovery.

Main Methods:

• Secondary analysis of 3-D transvaginal US images from vaginal delivery (n=15) and C-section (n=10) control groups.
• Texture features extracted using six classical analysis techniques; feature reduction via Pearson correlation coefficient (PCC).
• Random Forest classification model trained on selected features (identified by at least two methods) for time-point discrimination.

Main Results:

• Four texture features identified as potential biomarkers for LA muscle structural changes during recovery.
• Significant average percentage changes (12.2% ± 2.3%) in these features observed between 2-6 weeks postpartum in the vaginal delivery group.
• Random Forest model achieved 78% accuracy in distinguishing different postpartum time points.

Conclusions:

• 3-D US image texture analysis detects systematic muscle echotexture changes during the critical 2-6 week postpartum healing period.
• This objective approach complements subjective evaluation methods for LA muscle recovery.
• Potential to quantify healing rates, compare recovery protocols, and improve patient outcomes in pelvic floor disorder management.