Ultrasound examination of the pelvic floor during active labor: A longitudinal cohort study
INTRODUCTION: There is limited evidence about changes in the pelvic floor during active labor. We aimed to investigate changes in hiatal dimensions during the active first stage of labor and associations with fetal descent and head position. MATERIAL AND METHODS: We conducted a longitudinal, prospec...
Published in: | Acta Obstetricia et Gynecologica Scandinavica |
---|---|
Main Authors: | , , , , |
Format: | Text |
Language: | English |
Published: |
John Wiley and Sons Inc.
2023
|
Subjects: | |
Online Access: | http://www.ncbi.nlm.nih.gov/pmc/articles/PMC10407019/ http://www.ncbi.nlm.nih.gov/pubmed/37417688 https://doi.org/10.1111/aogs.14620 |
id |
ftpubmed:oai:pubmedcentral.nih.gov:10407019 |
---|---|
record_format |
openpolar |
spelling |
ftpubmed:oai:pubmedcentral.nih.gov:10407019 2023-09-05T13:20:37+02:00 Ultrasound examination of the pelvic floor during active labor: A longitudinal cohort study Eggebø, Torbjørn M. Benediktsdottir, Sigurlaug Hjartardottir, Hulda Salvesen, Kjell Å. Volløyhaug, Ingrid 2023-07-07 http://www.ncbi.nlm.nih.gov/pmc/articles/PMC10407019/ http://www.ncbi.nlm.nih.gov/pubmed/37417688 https://doi.org/10.1111/aogs.14620 en eng John Wiley and Sons Inc. http://www.ncbi.nlm.nih.gov/pmc/articles/PMC10407019/ http://www.ncbi.nlm.nih.gov/pubmed/37417688 http://dx.doi.org/10.1111/aogs.14620 © 2023 The Authors. Acta Obstetricia et Gynecologica Scandinavica published by John Wiley & Sons Ltd on behalf of Nordic Federation of Societies of Obstetrics and Gynecology (NFOG). https://creativecommons.org/licenses/by-nc-nd/4.0/This is an open access article under the terms of the http://creativecommons.org/licenses/by-nc-nd/4.0/ (https://creativecommons.org/licenses/by-nc-nd/4.0/) License, which permits use and distribution in any medium, provided the original work is properly cited, the use is non‐commercial and no modifications or adaptations are made. Acta Obstet Gynecol Scand Birth Text 2023 ftpubmed https://doi.org/10.1111/aogs.14620 2023-08-13T00:57:22Z INTRODUCTION: There is limited evidence about changes in the pelvic floor during active labor. We aimed to investigate changes in hiatal dimensions during the active first stage of labor and associations with fetal descent and head position. MATERIAL AND METHODS: We conducted a longitudinal, prospective cohort study at the National University Hospital of Iceland, from 2016 to 2018. Nulliparous women with spontaneous onset of labor, a single fetus in cephalic presentation, and gestational age ≥37 weeks were eligible. Fetal position was assessed with transabdominal ultrasound and fetal descent was measured with transperineal ultrasound. Three‐dimensional volumes were acquired from transperineal scanning at the start of the active phase of labor and in late first stage or early second stage. The largest transverse hiatal diameter was measured in the plane of minimal hiatal dimensions. The levator urethral gap was measured as the distance between the center of the urethra and the levator insertion using tomographic ultrasound imaging. Measurements of the levator urethral gap were made in the plane of minimal hiatal dimensions and 2.5 and 5 mm cranial to this. RESULTS: The final study population comprised 78 women. The mean transverse hiatal diameter increased 12.4% between the two examinations, from 39.4 ± 4.1 mm (±standard deviation) at the first examination to 44.3 ± 5.8 mm at the last examination (p < 0.01). We found a moderate correlation between the transverse hiatal diameter and fetal station at the last examination (r = 0.44, r (2) = 0.19; p < 0.01; regression equation y = 2.71 + 0.014x), and a weak correlation between the change in transverse hiatal diameter and change in fetal station (r = 0.29; r (2) = 0.08; p = 0.01; regression equation y = 0.24 + 0.012x). Levator urethral gap increased significantly in all three planes on both the left and right sides. Head position was not associated with hiatal measurements after adjusting for fetal station. CONCLUSIONS: We found a significant, but only modest, ... Text Iceland PubMed Central (PMC) Acta Obstetricia et Gynecologica Scandinavica 102 9 1203 1209 |
institution |
Open Polar |
collection |
PubMed Central (PMC) |
op_collection_id |
ftpubmed |
language |
English |
topic |
Birth |
spellingShingle |
Birth Eggebø, Torbjørn M. Benediktsdottir, Sigurlaug Hjartardottir, Hulda Salvesen, Kjell Å. Volløyhaug, Ingrid Ultrasound examination of the pelvic floor during active labor: A longitudinal cohort study |
topic_facet |
Birth |
description |
INTRODUCTION: There is limited evidence about changes in the pelvic floor during active labor. We aimed to investigate changes in hiatal dimensions during the active first stage of labor and associations with fetal descent and head position. MATERIAL AND METHODS: We conducted a longitudinal, prospective cohort study at the National University Hospital of Iceland, from 2016 to 2018. Nulliparous women with spontaneous onset of labor, a single fetus in cephalic presentation, and gestational age ≥37 weeks were eligible. Fetal position was assessed with transabdominal ultrasound and fetal descent was measured with transperineal ultrasound. Three‐dimensional volumes were acquired from transperineal scanning at the start of the active phase of labor and in late first stage or early second stage. The largest transverse hiatal diameter was measured in the plane of minimal hiatal dimensions. The levator urethral gap was measured as the distance between the center of the urethra and the levator insertion using tomographic ultrasound imaging. Measurements of the levator urethral gap were made in the plane of minimal hiatal dimensions and 2.5 and 5 mm cranial to this. RESULTS: The final study population comprised 78 women. The mean transverse hiatal diameter increased 12.4% between the two examinations, from 39.4 ± 4.1 mm (±standard deviation) at the first examination to 44.3 ± 5.8 mm at the last examination (p < 0.01). We found a moderate correlation between the transverse hiatal diameter and fetal station at the last examination (r = 0.44, r (2) = 0.19; p < 0.01; regression equation y = 2.71 + 0.014x), and a weak correlation between the change in transverse hiatal diameter and change in fetal station (r = 0.29; r (2) = 0.08; p = 0.01; regression equation y = 0.24 + 0.012x). Levator urethral gap increased significantly in all three planes on both the left and right sides. Head position was not associated with hiatal measurements after adjusting for fetal station. CONCLUSIONS: We found a significant, but only modest, ... |
format |
Text |
author |
Eggebø, Torbjørn M. Benediktsdottir, Sigurlaug Hjartardottir, Hulda Salvesen, Kjell Å. Volløyhaug, Ingrid |
author_facet |
Eggebø, Torbjørn M. Benediktsdottir, Sigurlaug Hjartardottir, Hulda Salvesen, Kjell Å. Volløyhaug, Ingrid |
author_sort |
Eggebø, Torbjørn M. |
title |
Ultrasound examination of the pelvic floor during active labor: A longitudinal cohort study |
title_short |
Ultrasound examination of the pelvic floor during active labor: A longitudinal cohort study |
title_full |
Ultrasound examination of the pelvic floor during active labor: A longitudinal cohort study |
title_fullStr |
Ultrasound examination of the pelvic floor during active labor: A longitudinal cohort study |
title_full_unstemmed |
Ultrasound examination of the pelvic floor during active labor: A longitudinal cohort study |
title_sort |
ultrasound examination of the pelvic floor during active labor: a longitudinal cohort study |
publisher |
John Wiley and Sons Inc. |
publishDate |
2023 |
url |
http://www.ncbi.nlm.nih.gov/pmc/articles/PMC10407019/ http://www.ncbi.nlm.nih.gov/pubmed/37417688 https://doi.org/10.1111/aogs.14620 |
genre |
Iceland |
genre_facet |
Iceland |
op_source |
Acta Obstet Gynecol Scand |
op_relation |
http://www.ncbi.nlm.nih.gov/pmc/articles/PMC10407019/ http://www.ncbi.nlm.nih.gov/pubmed/37417688 http://dx.doi.org/10.1111/aogs.14620 |
op_rights |
© 2023 The Authors. Acta Obstetricia et Gynecologica Scandinavica published by John Wiley & Sons Ltd on behalf of Nordic Federation of Societies of Obstetrics and Gynecology (NFOG). https://creativecommons.org/licenses/by-nc-nd/4.0/This is an open access article under the terms of the http://creativecommons.org/licenses/by-nc-nd/4.0/ (https://creativecommons.org/licenses/by-nc-nd/4.0/) License, which permits use and distribution in any medium, provided the original work is properly cited, the use is non‐commercial and no modifications or adaptations are made. |
op_doi |
https://doi.org/10.1111/aogs.14620 |
container_title |
Acta Obstetricia et Gynecologica Scandinavica |
container_volume |
102 |
container_issue |
9 |
container_start_page |
1203 |
op_container_end_page |
1209 |
_version_ |
1776201276389851136 |