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Open Access 01-09-2018 | Original Article

Method and reliability of measuring midurethral area and echogenicity, and changes during and after pregnancy

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

Published in: International Urogynecology Journal | Issue 9/2018

Abstract

Introduction and hypothesis

Internal closure of the urethral sphincter is one of the mechanisms in maintaining continence. Little is known about changes in the urethral sphincter during pregnancy. We designed this study to develop a reliable method to measure the area and mean echogenicity of the midurethra during and after pregnancy and to assess changes over time.

Methods

Two observers independently segmented the urethra as follows: in the sagittal plane, the urethra was positioned vertically, the marker was placed in the middle section of the lumen of the urethra, and eight tomographic US images of 2.5 -mm slices were obtained. The central image was selected, and area and mean echogenicity were calculated automatically. Intra- and interobserver reliability were determined by intraclass correlation coefficients (ICC) and their 95% confidence intervals (CI). Two hundred and eighty women underwent TPUS at 12 weeks and 36 weeks of gestation and 6 months postpartum, and 3D/4D transperineal ultrasound (TPUS) images of 40 pregnant nulliparous women were used for the reliability study. Paired t tests were used to assess changes in echogenicity and area.

Results

The ICC for measuring the area was substantial, at 0.77 and for measuring mean echogenicity was almost perfect, at 0.86. In the total study group (n = 280), midurethral area and mean echogenicity were significantly lower 6 months after delivery compared with 12 and 36 weeks of gestation.

Conclusions

Our protocol for measuring area and mean echogenicity of the midurethra is reliable. This study indicates that structural changes in the midurethraoccur during pregnancy.

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Title: Method and reliability of measuring midurethral area and echogenicity, and changes during and after pregnancy
Authors: Maria K. van de Waarsenburg
Nienke E. van Hoogenhuijze
Anique T. M. Grob
Karlijn J. Schweitzer
Mariëlla I. J. Withagen
Carl H. van der Vaart
Publication date: 01-09-2018
Publisher: Springer London
Published in: International Urogynecology Journal / Issue 9/2018
Print ISSN: 0937-3462
Electronic ISSN: 1433-3023
DOI: https://doi.org/10.1007/s00192-018-3580-z

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Method and reliability of measuring midurethral area and echogenicity, and changes during and after pregnancy

Abstract

Introduction and hypothesis

Methods

Results

Conclusions

Keynote webinar | Spotlight on sleep in brain health

Springer Medicine

Abstract

Introduction and hypothesis

Methods

Results

Conclusions

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