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Open Access 01-06-2016 | Original Article

Changes in the mean echogenicity and area of the puborectalis muscle during pregnancy and postpartum

Authors: Anique T. M. Grob, Mariella I. J. Withagen, Maria K. van de Waarsenburg, Karlijn J. Schweitzer, Carl H. van der Vaart

Published in: International Urogynecology Journal | Issue 6/2016

Abstract

Introduction and hypothesis

Three-dimensional (3D) and four-dimensional (4D) volume transperineal ultrasound imaging is increasingly used to assess changes in the dimensions of the pelvic floor during pregnancy and after delivery. Little is known with regard to the area of the puborectalis muscle and its structural changes. Echogenicity measurement, a parameter that provides information on the structure of muscles, is increasingly used in orthopaedics and neuromuscular disease evaluation. This study is aimed at assessing the changes in the mean echogenicity of the puborectalis muscle (MEP) and the puborectalis muscle area (PMA) during first pregnancy and after childbirth.

Methods

The MEP and PMA of 254 women during first pregnancy were measured at 12 and 36 weeks’ gestation and 6 months postpartum. To determine the effect of child-birth on MEP and PMA, the results at 6 months postpartum were separately analysed for vaginal deliveries, operative vaginal deliveries (ventouse) and caesarean section deliveries. Mean differences in MEP and PMA were analysed using ANOVA statistics.

Results

The MEP at 6 months postpartum was, independent of manoeuvre, significantly (p < 0.001) lower than MEP values during pregnancy. After caesarean delivery, the PMA was significantly smaller at maximum pelvic floor contraction than PMA after vaginal delivery (p = 0.003) or operative vaginal delivery (p = 0.002).

Conclusion

Our study indicates that structural changes in the puborectalis muscle during and after pregnancy, as measured by MEP, occur and can be analysed. In addition, the mode of delivery affects the area of the puborectalis during contraction after delivery. For true volume analysis, as part of an assessment of contractility of the puborectalis muscle we will need 3D volume analysis.

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Title: Changes in the mean echogenicity and area of the puborectalis muscle during pregnancy and postpartum
Authors: Anique T. M. Grob
Mariella I. J. Withagen
Maria K. van de Waarsenburg
Karlijn J. Schweitzer
Carl H. van der Vaart
Publication date: 01-06-2016
Publisher: Springer London
Published in: International Urogynecology Journal / Issue 6/2016
Print ISSN: 0937-3462
Electronic ISSN: 1433-3023
DOI: https://doi.org/10.1007/s00192-015-2905-4

At a glance: The ONWARDS insulin icodec trials

Springer Medicine

Changes in the mean echogenicity and area of the puborectalis muscle during pregnancy and postpartum

Abstract

Introduction and hypothesis

Methods

Results

Conclusion

At a glance: The ONWARDS insulin icodec trials

Springer Medicine

Abstract

Introduction and hypothesis

Methods

Results

Conclusion

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