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International Urogynecology Journal
Published in: International Urogynecology Journal 11/2020

01-11-2020 | Original Article

Change in levator ani muscle stiffness and active force during pregnancy and post-partum

Authors: Melissa J. Davidson, Poul M. F. Nielsen, Andrew J. Taberner, Jennifer A. Kruger

Published in: International Urogynecology Journal | Issue 11/2020

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Abstract

Introduction and hypothesis

It is assumed changes occur to the biomechanics and viscoelastic response of the levator ani muscle during pregnancy; however, there is limited evidence of this. This study used instrumentation and clinical measures to determine the stiffness and active force capacity of levator ani muscle during pregnancy and post-partum, investigated any associations with delivery outcomes, and explored the biomechanical properties associated with symptoms of pelvic floor dysfunction.

Methods

This was a prospective observational study, with nulliparous women with a singleton low-risk pregnancy. Data were collected at two stages during pregnancy and post-partum. Measurements included the Australian Pelvic Floor Questionnaire, palpation of active force, and elastometry measurements. Post-partum, 3D/4D ultrasound measurements were included. Repeated measures ANOVAs, pairwise comparisons, Pearson correlation coefficients, and Student’s t-tests were used as appropriate.

Results

Fifty-nine women took part in the study. Active force was significantly different over the pregnancy and post-partum, measured with instrumentation (p = 0.002) and palpation (p = 0.006 right, p = 0.029 left). There was no significant change in muscle stiffness during pregnancy. Post-partum muscle stiffness was significantly different between women who gave birth vaginally vs. caesarean section (p = 0.002). Post-partum there were differences in levator hiatal area, symptoms of bladder dysfunction, prolapse symptoms, and sexual dysfunction symptoms.

Conclusions

Active force of the levator ani muscle was significantly reduced during pregnancy and in the post-partum period, while muscle stiffness reduced only in those who had vaginal deliveries.
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Metadata
Title
Change in levator ani muscle stiffness and active force during pregnancy and post-partum
Authors
Melissa J. Davidson
Poul M. F. Nielsen
Andrew J. Taberner
Jennifer A. Kruger
Publication date
01-11-2020
Publisher
Springer International Publishing
Published in
International Urogynecology Journal / Issue 11/2020
Print ISSN: 0937-3462
Electronic ISSN: 1433-3023
DOI
https://doi.org/10.1007/s00192-020-04493-0

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