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

01-11-2020 | Perineal Laceration | Original Article

Prediction of levator ani muscle avulsion by genital tears after vaginal birth—a prospective observational cohort study

Authors: Nina Kimmich, Jana Birri, Roland Zimmermann, Martina Kreft

Published in: International Urogynecology Journal | Issue 11/2020

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Abstract

Introduction

Visible birth tears and levator ani muscle (LAM) trauma are common after birth. For the diagnosis of LAM trauma ultrasound evaluation is advisable. As ultrasound equipment and trained personnel are not available everywhere at all times, we aimed to evaluate whether specific overt birth tears are an indicator for LAM trauma.

Methods

In a prospective cohort study at our center from March 2017–April 2019, we evaluated vaginal births of nulliparous women with singletons in vertex presentation ≥ 36 + 0 gestational weeks for LAM trauma by translabial ultrasound and for overt birth tears by inspection. We then calculated the association of overt birth tears with complete LAM avulsion.

Results

Of 213 women, 23.9% had any kind of LAM trauma, with 14.1% being complete avulsions. In univariate analysis, solely high-grade perineal tears (OASIS) were significantly associated with complete LAM avulsions.

Conclusions

Fourteen percent of women suffered a complete LAM avulsion after vaginal birth, with OASIS being the only associated parameter of significance. The occurrence of such trauma might be an indicator for a mismatch between the size of the fetus and the structures of the birth canal, leading to birth trauma. Assessing for LAM trauma by translabial ultrasound in women with OASIS might be worthwhile.
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Metadata
Title
Prediction of levator ani muscle avulsion by genital tears after vaginal birth—a prospective observational cohort study
Authors
Nina Kimmich
Jana Birri
Roland Zimmermann
Martina Kreft
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/s00192-020-04297-2

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