Evaluation of Levator ani muscle injury in primiparous women at one and six weeks’ post-partum using 3D transperineal ultrasound: comparative Cohort study

ABSTRACT
Background. Vaginal birth is known to be the main etiological factor for development of levator ani defects. Transperineal ultrasonography has been used extensively for pelvic floor assessment with minimal discomfort to the patient and lower cost. The aim is to define and evaluate changes in the levator ani muscle in the first week and at 6 weeks after delivery with 3D Transperineal ultrasonography.
Patients and Methods. Retrospective study of 355 eligible primiparous women who delivered vaginally and had been examined within the first week and 6 weeks after delivery with 3D transperineal ultrasonography.
Results. Women showed a significantly larger hiatal area at rest and on Valsalva, 6 weeks post-partum, LAM avulsions decreased at 6 weeks to be 13.2%.
Conclusions. First vaginal delivery led to persistent hiatal area enlargement. Levator ani muscle avulsions can be diagnosed easily by 3D ultrasound, and they are not the only cause of stress urinary incontinence after vaginal delivery.