Tomographic ultrasound evaluation of avulsion of the levator ani in postpartum women according to delivery mode

doi:10.3877/cma.j.issn.1672-6448.2016.03.009

Abstract

Abstract:

Objective

Tomographic ultrasound imaging (TUI) was applied to observe the levator ani injury in postpartum women according to delivery mode. It was also analyzed about the influence of obstetric factors on the levator ani injury.

Methods

Translabial 3D ultrasound observation was performed on 154 rimiparas (spontaneous vaginal delivery in 85 cases, forceps delivery in 15 cases, cesarean delivery in 50 cases) from Shanghai Jiaotong University Affiliated Sixth People′s Hospital during April, 2013 to February, 2014. TUI was applied to evaluate the situation of levator ani injury. The t-test was used to analyze the differences between the injured levator ani group and the normal levator ani group including postpartum women′s ages, body mass index (BMI) before pregnancy, BMI on ultrasound examination, children birth weight and the time of second stage during labor.

Results

Nine cases of the levator ani muscle avulsion were observed in spontaneous vaginal delivery group (the avulsion incidence rate was 10.58%, 9/85), and 8 cases of the levator ani muscle avulsion were found in forceps delivery group (the avulsion incidence rate was 53.33%, 8/15). No levator ani muscle avulsion was shown in the cesarean delivery group. The second stage of labor was obvious longer in avulsion group compared with the normal group, it had significant statistical difference between the two groups [(90.00±30.10) min vs (40.71±26.53) min, t=3.24, P<0.05]. However, age, BMI before pregnancy, BMI on ultrasound examination and children birth weight had no significant statistical difference between the two groups.

Conclusions

On TUI, the avulsion incidence rate in forceps delivery was apparently higher than that in spontaneous vaginal delivery and in cesarean delivery. There is a probabe relation between levator avulsion and longer second stage of labor.

Key words: Tomographic ultrasound imaging, Levator ani muscle, Delivery mode

Yun Bai, Lian Xu, Feifei Liu, Tao Ying. Tomographic ultrasound evaluation of avulsion of the levator ani in postpartum women according to delivery mode[J]. Chinese Journal of Medical Ultrasound (Electronic Edition), 2016, 13(03): 209-212.

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Figures/Tables 5

References 17

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组别	例数	年龄（岁）	孕前体重指数（kg/m²）	超声检查时体重指数（kg/m²）	产后时间（d）	新生儿出生体重（g）
经阴道自然分娩组	85	29.18±4.04	20.56±3.02	22.49±3.02	52.64±6.35	3297.68±340.18
经阴道产钳助产组	15	29.20±4.44	20.24±2.20	22.80±2.83	51.33±4.22	3222.33±453.90
剖宫产组	50	28.78±2.94	20.93±3.02	22.74±2.78	54.04±5.32	3390.70±488.58
F值	?	3.05	2.79	1.06	2.57	2.89
P值	?	>0.05	>0.05	>0.05	>0.05	>0.05

组别	例数	年龄（岁）	孕前体重指数（kg/m²）	超声检查时体重指数（kg/m²）	产后时间（d）	新生儿出生体重（g）
经阴道自然分娩组	85	29.18±4.04	20.56±3.02	22.49±3.02	52.64±6.35	3297.68±340.18
经阴道产钳助产组	15	29.20±4.44	20.24±2.20	22.80±2.83	51.33±4.22	3222.33±453.90
剖宫产组	50	28.78±2.94	20.93±3.02	22.74±2.78	54.04±5.32	3390.70±488.58
F值	?	3.05	2.79	1.06	2.57	2.89
P值	?	>0.05	>0.05	>0.05	>0.05	>0.05

组别	例数	产妇年龄（岁）	孕前体重指数（kg/m²）	超声检查时体重指数（kg/m²）	新生儿出生体质量（g）	第二产程时间（min）
肛提肌损伤组	17	28.76±3.94	20.02±2.35	22.32±2.74	3306.47±379.52	90.00±30.10
肛提肌未损伤组	17	29.15±4.13	20.62±3.08	22.58±3.04	3282.26±355.53	40.71±26.53
t值	?	0.79	1.18	0.85	0.76	3.24
P值	?	>0.05	>0.05	>0.05	>0.05	<0.05

组别	例数	产妇年龄（岁）	孕前体重指数（kg/m²）	超声检查时体重指数（kg/m²）	新生儿出生体质量（g）	第二产程时间（min）
肛提肌损伤组	17	28.76±3.94	20.02±2.35	22.32±2.74	3306.47±379.52	90.00±30.10
肛提肌未损伤组	17	29.15±4.13	20.62±3.08	22.58±3.04	3282.26±355.53	40.71±26.53
t值	?	0.79	1.18	0.85	0.76	3.24
P值	?	>0.05	>0.05	>0.05	>0.05	<0.05

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