A prospective observational study on the influence of the difficulty of forceps application and the avulsion of the levator ani muscle
Background: To compare the rate of levator ani muscle (LAM) avulsion between normal deliveries (ND) and forceps deliveries (FD) and to determine whether the difficulty of forceps application in FD is related to the occurrence of LAM avulsion. Methods: This prospective observational study included 24...
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IMR Press
2022-03-01
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| Series: | Clinical and Experimental Obstetrics & Gynecology |
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| Online Access: | https://www.imrpress.com/journal/CEOG/49/3/10.31083/j.ceog4903067 |
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| author | José Antonio García-Mejido Ana Fernández-Palacín Rocio García-Jimenez Laura Castro Portillo Adriana Aquise José Antonio Sainz Bueno |
| author_facet | José Antonio García-Mejido Ana Fernández-Palacín Rocio García-Jimenez Laura Castro Portillo Adriana Aquise José Antonio Sainz Bueno |
| author_sort | José Antonio García-Mejido |
| collection | DOAJ |
| description | Background: To compare the rate of levator ani muscle (LAM) avulsion between normal deliveries (ND) and forceps deliveries (FD) and to determine whether the difficulty of forceps application in FD is related to the occurrence of LAM avulsion. Methods: This prospective observational study included 240 primiparous patients (125 ND and 115 FD). FD were classified according to the difficulty of forceps application. The application was considered difficult if the fetal head was in a transverse position or if it was midforceps (head engaged by the leading part was above +2 stations) with the fetal head in the occipito-posterior position; otherwise, the application was considered easy. Ultrasound evaluation was performed 6 months after delivery, and complete avulsion was diagnosed when there was abnormal insertion of the LAM in all three central slices. Results: There were statistically significant differences between the ND and FD groups in the presence of LAM avulsion (15.6% vs. 38.3%; p < 0.0005), with a crude Odds Ratio (OR) of 3.36 and an adjusted OR of 4.219. However, there were no statistically significant differences in the LAM avulsion rates between the easy and difficult application groups (34.2% vs. 45.2%; p: 0.244). Conclusions: FD have higher rates of LAM avulsion than ND, although the difficulty of forceps application does not have an influence on the rates of LAM avulsion. |
| format | Article |
| id | doaj-art-6265f0a20d8f4321925ff463e2a430c2 |
| institution | Kabale University |
| issn | 0390-6663 |
| language | English |
| publishDate | 2022-03-01 |
| publisher | IMR Press |
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| series | Clinical and Experimental Obstetrics & Gynecology |
| spelling | doaj-art-6265f0a20d8f4321925ff463e2a430c22025-08-20T03:48:32ZengIMR PressClinical and Experimental Obstetrics & Gynecology0390-66632022-03-014936710.31083/j.ceog4903067S0390-6663(22)01718-3A prospective observational study on the influence of the difficulty of forceps application and the avulsion of the levator ani muscleJosé Antonio García-Mejido0Ana Fernández-Palacín1Rocio García-Jimenez2Laura Castro Portillo3Adriana Aquise4José Antonio Sainz Bueno5Department of Obstetrics and Gynecology, Valme University Hospital, 41014 Seville, SpainBiostatistics Unit, Department of Preventive Medicine and Public Health, University of Seville, 41001 Sevilla, SpainDepartment of Obstetrics and Gynecology, Valme University Hospital, 41014 Seville, SpainDepartment of Obstetrics and Gynecology, Valme University Hospital, 41014 Seville, SpainDepartment of Obstetrics and Gynecology, University of Seville, 41001 Sevilla, SpainDepartment of Obstetrics and Gynecology, Valme University Hospital, 41014 Seville, SpainBackground: To compare the rate of levator ani muscle (LAM) avulsion between normal deliveries (ND) and forceps deliveries (FD) and to determine whether the difficulty of forceps application in FD is related to the occurrence of LAM avulsion. Methods: This prospective observational study included 240 primiparous patients (125 ND and 115 FD). FD were classified according to the difficulty of forceps application. The application was considered difficult if the fetal head was in a transverse position or if it was midforceps (head engaged by the leading part was above +2 stations) with the fetal head in the occipito-posterior position; otherwise, the application was considered easy. Ultrasound evaluation was performed 6 months after delivery, and complete avulsion was diagnosed when there was abnormal insertion of the LAM in all three central slices. Results: There were statistically significant differences between the ND and FD groups in the presence of LAM avulsion (15.6% vs. 38.3%; p < 0.0005), with a crude Odds Ratio (OR) of 3.36 and an adjusted OR of 4.219. However, there were no statistically significant differences in the LAM avulsion rates between the easy and difficult application groups (34.2% vs. 45.2%; p: 0.244). Conclusions: FD have higher rates of LAM avulsion than ND, although the difficulty of forceps application does not have an influence on the rates of LAM avulsion.https://www.imrpress.com/journal/CEOG/49/3/10.31083/j.ceog49030673d transperineal ultrasoundpelvic floordeliverylevator ani muscleforceps delivery |
| spellingShingle | José Antonio García-Mejido Ana Fernández-Palacín Rocio García-Jimenez Laura Castro Portillo Adriana Aquise José Antonio Sainz Bueno A prospective observational study on the influence of the difficulty of forceps application and the avulsion of the levator ani muscle Clinical and Experimental Obstetrics & Gynecology 3d transperineal ultrasound pelvic floor delivery levator ani muscle forceps delivery |
| title | A prospective observational study on the influence of the difficulty of forceps application and the avulsion of the levator ani muscle |
| title_full | A prospective observational study on the influence of the difficulty of forceps application and the avulsion of the levator ani muscle |
| title_fullStr | A prospective observational study on the influence of the difficulty of forceps application and the avulsion of the levator ani muscle |
| title_full_unstemmed | A prospective observational study on the influence of the difficulty of forceps application and the avulsion of the levator ani muscle |
| title_short | A prospective observational study on the influence of the difficulty of forceps application and the avulsion of the levator ani muscle |
| title_sort | prospective observational study on the influence of the difficulty of forceps application and the avulsion of the levator ani muscle |
| topic | 3d transperineal ultrasound pelvic floor delivery levator ani muscle forceps delivery |
| url | https://www.imrpress.com/journal/CEOG/49/3/10.31083/j.ceog4903067 |
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