Prevalence of Perineal Injury After First Vaginal Delivery and Its Association With Pregnancy and Birth...

The onset of symptoms associated with pelvic floor dysfunctions and injuries after pregnancy and childbirth has been well documented and studied. Avulsion of the levator ani muscle (LAM) is known to be a risk factor for these conditions. This study aimed to evaluate the prevalence of LAM avulsion in patients after their first vaginal delivery, associating this finding with factors related to pregnancy and birth.

In a cross-sectional study, we evaluated 100 postpartum women after their first vaginal delivery to identify LAM avulsion using ultrasound imaging and to correlate the presence of this injury with pregnancy and birth-related factors.

Of the 100 primiparous women evaluated, 46% had some degree of avulsion after delivery. Among these, 37% had complete and 63% had partial avulsion. Regarding laterality, 63% of the lesions were unilateral, affecting the muscle asymmetrically, and 37% were bilateral. The weight of the newborn was a significant factor and showed a statistically significant difference between the groups with and without avulsion. Another statistically significant difference observed between the groups was forceps delivery.

The impact of pregnancy and childbirth factors on the pelvic floor muscles is not yet fully elucidated. Identifying these factors is crucial for developing multidisciplinary strategies to prevent such injuries during pregnancy and delivery, thereby reducing their consequences and impact on women's quality of life.