Morphological changes of levator hiatus in primiparas with pelvic organ prolapse without levator avulsion
Objective To explore the abnormal changes in the hiatus morphology of the levator anal muscle in women with pelvic organ prolapse(POP)without avulsion.Methods One hundred and seven primiparas who delivered vaginally without avulsion of the levator anal muscle were collected.Of these patients,65 primiparas with POP were divided into a maternal POP group and 42 primiparas without POP were divided into a maternal control group.The morphological parameters of anal levator hiatus of the parturient women under the states of rest and maximum Valsalva were collected by perineal 4D pelvic floor ultrasound.The parameters included anterior and posterior diameter of anal levator hiatus(LHAP),left and right diameter of anal levator hiatus(LHLD),circumferential diameter of anal levator hiatus(LHC)and anal levator hiatus area(LHA).Results There was no statistical significance in LHAP,LHLD,LHC and LHA between the two groups under the rest state(P>0.05).The LHAP,LHLD,LHC and LHA in the maternal POP group were higher than those in the control group under the state of maximum Valsalva(P<0.05).When LHA>18.84 cm2under the state of the maximum Valsalva,the sensitivity of POP was 73.8%,the specificity was 95.2%and the AUC of ROC curve was 0.912.Conclusions The levator anal muscle may be damaged in the first vaginal delivery of POP primipara who do not have avulsion of levator anal muscle.The morphological changes of the levator anal muscle hiatus under 4D pelvic floor ultrasound can reflect whether the levator anal muscle is injured and the degree of injury.especially the area of the levator anal muscle hiatus under the maximum Valsalva state has a good correlation with POP.
4D pelvic floor ultrasoundPelvic organ prolapseLevator anal muscle
NETL
NSTL
万方数据
