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Translabial three-dimensional ultrasound investigation of the levator hiatus in postpartum women

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Abstract

Purpose

This study utilized translabial three-dimensional ultrasound to investigate the morphological characteristics of the levator hiatus and provide sonographic evidence for assessing pelvic floor dysfunction in postpartum women.

Methods

Two-hundred and one singleton primiparae without any complications underwent translabial three-dimensional ultrasound at 6 and 18 weeks after delivery, with 12 participants lost to follow-up at 18 weeks. Fifty nulliparae were enrolled as the control group. Levator hiatal morphology at rest and on Valsalva maneuver was assessed by experienced sonographers, specifically evaluating the anteroposterior diameter, left-to-right diameter, and area.

Results

In postpartum women at 6 weeks after delivery, all the levator hiatal parameters were significantly higher compared with those of the control group. At 18 weeks, the hiatal parameters were better than at 6 weeks but still higher than in the nulliparous controls. In all three groups, the hiatal parameters were significantly higher during the Valsalva maneuver than at rest.

Conclusions

Postpartum women are prone to develop pelvic floor dysfunction as shown by an enlarged levator hiatus. Translabial three-dimensional ultrasound can be used to effectively assess the morphology and structural alterations of the levator hiatus in postpartum women, providing reliable pelvic floor imaging for early screening, diagnosis, and prevention of pelvic floor dysfunction.

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Acknowledgments

This study was supported by the Joint Key Project of New Frontier Technology in Shanghai Municipal Hospitals (No. SHDC12013120) and the Project of the Science and Technology Commission of Shanghai Municipality (No. 124119a5501).

Conflict of interest

All authors declare no conflict of interest.

Human rights statements and informed consent

All procedures followed were in accordance with the ethical standards of the responsible committee on human experimentation (institutional and national) and with the Helsinki Declaration of 1975, as revised in 2008 (5). Informed consent was obtained from all patients for being included in the study.

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Author notes

    Authors and Affiliations

    1. Department of Ultrasound, Obstetrics and Gynecology Hospital of Fudan University, Shanghai, China

      Xue-Mei Wang & Fan-Bin Kong

    2. Huai’an First People’s Hospital, Nanjing Medical University, Jiangsu, China

      Xin Chang & Yin Zhen

    3. Department of Gynecology, Obstetrics and Gynecology Hospital of Fudan University, Shanghai, China

      Yan Ding, Su-Zhen Wang & Jing-Xin Ding

    Authors
    1. Xue-Mei Wang
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    2. Xin Chang
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    3. Yan Ding
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    4. Su-Zhen Wang
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    5. Yin Zhen
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    6. Jing-Xin Ding
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    7. Fan-Bin Kong
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    Corresponding author

    Correspondence to Fan-Bin Kong.

    Additional information

    X.-M. Wang and X. Chang contributed equally to the work.

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    Wang, XM., Chang, X., Ding, Y. et al. Translabial three-dimensional ultrasound investigation of the levator hiatus in postpartum women. J Med Ultrasonics 42, 373–378 (2015). https://doi.org/10.1007/s10396-014-0609-x

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    • DOI: https://doi.org/10.1007/s10396-014-0609-x

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