Department of Ultrasound in Medicine, Shanghai Jiao Tong University Affiliated Sixth People's Hospital; Shanghai Institute of Ultrasound in Medicine, Shanghai, People's Republic of China.
This study investigated the morphology and structure of pelvic floor in 50 nulliparous and 95 postpartum women (47 vaginal delivery, 48 Cesarean section) using translabial three-dimensional (3D) ultrasound. All the primiparae underwent ultrasound examination within one week after their first delivery. Volume datasets were acquired and analyzed to determine the alterations of levator hiatus after childbirth. Significant differences were observed in the levator hiatus of postpartum women compared with that of nullipara women. In postpartum women, the levator hiatus, with their dimensions increased, expanded into a circular shape. Puborectalis was avulsed in eight cases (accounting for 8.42% of all) and pelvic organ prolapse was found in 12 cases (accounting for 12.63%). The hiatal dimensions were larger and the incidence of pubrectalis muscle avulsion (17.02% vs. 0%) and pelvic organ prolapse (21.28% vs. 4.17%) was significantly higher in Vaginal delivery group than Cesarean section group. In summary, 3D ultrasound is an effective tool to detect the pelvic floor of postpartum women who present with morphological abnormalities, and such abnormalities are more likely to show in vaginal delivery women compared to Cesarean section.
Keywords: Levator hiatus, Pelvic floor, Postpartum women, Delivery, Three-dimensional ultrasound.