Effect of different delivery ways on postpartum hiatus of levator ani evaluated by real-time three-dimensional pelvic floor ultrasound

ObjectiveTo investigate the effects of different delivery ways on the area of postpartum hiatus of levator ani evaluated by real-time three-dimensional pelvic floor ultrasound.

MethodsEighty postpartum 6 weeks women and 40 nulliparous women were divided into the case group and control group, respectively.The case group was subdivided into the transvaginal delivery group and selective cesarean section group.The areas of postpartum hiatus of levator ani at rest and after the maxium Valsalva movement among three groups were compared, the effects of different delivery ways on the area of postpartum hiatus of levator ani were evaluated, and the correlation of the area of hiatus of levator ani in different states with neonatal weight was anlayzed in transvaginal delivery group.

ResultsThe differences of the areas of hiatus of levator ani at rest and after the maxium Valsalva movement among three groups were statistically significant(P < 0.01), which in selective cesarean section group and control group was lower than that in transvaginal delivery group(P < 0.05 to P < 0.01), ans which in control group was lower than that in selective cesarean group(P < 0.01).The area of hiatus of levator ani at rest and after the maxium Valsalva movement in transvaginal delivery group was positively correlated with neonatal weight(r=0.865, 0.876).

ConclusionsThe transperineal real-time three-dimensional ultrasound in evaluating the postpartum pelvic floor structure by measuring the area of hiatus of levator ani is noninvasive, convenient and repetitive, which can be used as a routine screening method, and provide the basis in the evaluation of clinic diagnosis and treatment effect.