Levator ani muscle coactivation at term is associated with longer second stage of labor in nulliparous women.
Adult
Delivery, Obstetric
/ methods
Female
Humans
Labor Stage, Second
/ physiology
Muscle Contraction
/ physiology
Muscle, Skeletal
/ diagnostic imaging
Obstetric Labor Complications
/ etiology
Parity
Pelvic Floor
/ diagnostic imaging
Pregnancy
Proportional Hazards Models
Prospective Studies
Regression Analysis
Term Birth
/ physiology
Time Factors
Ultrasonography, Prenatal
/ methods
Valsalva Maneuver
/ physiology
Young Adult
coactivation
labor
levator ani muscle
pelvic floor
second stage
transperineal ultrasound
Journal
Ultrasound in obstetrics & gynecology : the official journal of the International Society of Ultrasound in Obstetrics and Gynecology
ISSN: 1469-0705
Titre abrégé: Ultrasound Obstet Gynecol
Pays: England
ID NLM: 9108340
Informations de publication
Date de publication:
May 2019
May 2019
Historique:
received:
01
07
2018
revised:
05
10
2018
accepted:
11
10
2018
pubmed:
26
10
2018
medline:
25
12
2019
entrez:
25
10
2018
Statut:
ppublish
Résumé
To assess the effect of levator ani muscle (LAM) coactivation at term on outcome of labor in nulliparous women. This was a prospective study of 284 low-risk nulliparous women with a singleton pregnancy at term recruited before the onset of labor. The anteroposterior diameter of the levator hiatus was measured in each woman on transperineal ultrasound at rest, on maximum pelvic floor muscle contraction and on maximum Valsalva maneuver before and after visual feedback. LAM coactivation was defined as a reduction in the anteroposterior diameter of the levator hiatus on maximum Valsalva maneuver in comparison with that at rest. The association of pelvic hiatal diameter values and LAM coactivation with mode of delivery and duration of labor was assessed. No significant difference was found between women who underwent Cesarean delivery and those who had a vaginal delivery with regard to the anteroposterior diameter of the levator hiatus at rest, on pelvic floor muscle contraction and on Valsalva maneuver. Longer second stage of labor was associated with shorter anteroposterior diameter of the levator hiatus on all assessments, but in particular at rest and on Valsalva both before and after visual feedback. LAM coactivation was found in 89 (31.3%) and 75 (26.4%) women before and after visual feedback, respectively. Post visual feedback, women with LAM coactivation had a significantly longer second stage of labor than did those without LAM coactivation (83 ± 63 vs 63 ± 42 min; P = 0.006). On Cox regression analysis, LAM coactivation post visual feedback was an independent predictor of longer second stage of labor (adjusted hazard ratio, 1.499 (95% CI, 1.076-2.087); P = 0.017). LAM coactivation in nulliparous women at term is associated with a longer second stage of labor. Copyright © 2018 ISUOG. Published by John Wiley & Sons Ltd.
Types de publication
Evaluation Study
Journal Article
Langues
eng
Sous-ensembles de citation
IM
Pagination
686-692Informations de copyright
Copyright © 2018 ISUOG. Published by John Wiley & Sons Ltd.