Levator trauma after vaginal delivery
Levator trauma after vaginal delivery
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DOI：
10.1097/01.aog.0000178779.62181.01
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发表时间：
2005-10-01
影响因子：
7.2
通讯作者：
Lanzarone, F
中科院分区：
文献类型：
--
作者：
Dietz, HP;Lanzarone, F
目的：到目前为止，由于缺乏比较分娩前后盆底影像的前瞻性研究，有关产程中盆底损伤的证据仍然很粗略。我们打算确定耻骨内脏肌肉的主要创伤的发生率。方法：在一项前瞻性观察研究中，共有61名未分娩妇女在妊娠36-40周被观察到。评估包括访谈和三维经唇部超声，并在产后2-6个月重复。结果：50名妇女(82%)在产后被看到。在39名经阴道分娩的妇女中，14人被诊断为提肌撕脱(36%，95%可信区间21-51%)。在经阴道分娩的产妇中，产妇年龄较高(P=.10)、经阴道手术分娩(P=.07)和产后压力性尿失禁加重(P=.02)均有关联。结论：在所有经阴道分娩的产妇中，约有三分之一发生提肛肌下内侧部分从盆腔侧壁撕脱，并与产后3个月的压力性尿失禁有关。
OBJECTIVE: To date, the evidence on pelvic floor injury in labor remains sketchy due to a lack of prospective studies comparing pelvic floor imaging before and after childbirth. We intended to define the incidence of major trauma to the pubovisceral muscle.METHODS: A total of 61 nulliparous women were seen at 36-40 weeks of gestation in a prospective observational study. The assessment included an interview and 3-dimensional translabial ultrasound and was repeated 2-6 months postpartum.RESULTS: Fifty women (82%) were seen postpartum. Of the 39 women delivered vaginally, levator avulsion was diagnosed in 14 (36%, 95% confidence interval 21-51%). Among those delivered vaginally, there were associations with higher maternal age (P = .10), vaginal operative delivery (P = .07), and worsened stress incontinence postpartum (P = .02).CONCLUSIONS: Avulsion of the inferomedial aspects of the levator ani from the pelvic sidewall occurred in approximately one third of all women delivered vaginally and was associated with stress incontinence 3 months after childbirth.