Evaluation for Postpartum Pelvic Floor Using 3-Dimention Endoanal and Enovaginal Ultrasonography
IUGA Academy. TAKAHASHI T. Jun 30, 2018; 212874; 374

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Evaluation for postpartum pelvic floor using 3-dimention endoanal and enovaginal ultrasonography

Takahashi, T1; Yagi, Y1; Tsunoda, A1; Kusanagi, H1; Suzuki, M1; Shimizu, Y1

1: Kameda Medical Center

Introduction: Vaginal delivery is well known to cause?incontinence of feces or urine, and pelvic organ prolapse occasionally. However, few studies demonstrated the pelvic floor image before and after the delivery.

[Objective] This study aimed to evaluate the image of postpartum pelvic floor using 3-dimention Endoanal(EAU) and Endovaginal Ultrasonography(EVU), prospectively.

Methods: Between May 2016 and September 2017, nulliparous women who were recruited at Kameda Medical Center examined 3-dimention EVU (B&K Medical, Flex Focus800, 8838) during pregnancy 36 week to her delivery. EVU and EAU were performed at one month after the delivery and imaged puborectalis(PM), bulbocavernosus(BCM), superficial transverse muscle(STM) and anal sphincter were identified. The area (LH area), the longitudinal(AL) and lateral diameter(LL) of levator hiatus were measured before and after the delivery. Urine and fecal incontinence were evaluated with International Consultation on Incontinence Questionnaire Short Form and the Fecal Incontinence Severity Index at one month after delivery.

Results: Eighty-five nulliparous women consented to this study. Fifty-six of 85 postpartum women underwent EVU after vaginal delivery. Ten underwent emergency caesarean section. Other obstetric interventions included painless labor in 6, vacuum in 15, forceps in 3, and episiotomy in 33. Forty-six of the 56 postpartum women were examined EAU. EVU showed PM tears in 43(76.7%), BCM tears in 17, and STM in 19. There was no significant postpartum difference in LH area, AP, and LL respectively. Anal sphincter tears were identified in 13 women(28.2%) who had been diagnosed no tear by obstetrician. Extremely slight urine incontinences were reported by 18 women. One primipara without anal sphincter tear was reported fecal incontinence at one month after delivery, but the symptom was relieved in a few months.

Conclusions: Puborectalis muscle tears were common among obstetric pelvic floor injury. Anal sphincter tears were diagnosis rarely without EAU. Postpartum women had no or slight incontinence after the delivery.


Work supported by industry: no.

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