Changes in the mean echogenicity and area of the puborectalis muscle during pregnancy and postpartum

• Published in: International Urogynecology Journal 2016-06, Vol.27 (6), p.895-901
• Main Authors: Grob, Anique T. M., Withagen, Mariella I. J., van de Waarsenburg, Maria K., Schweitzer, Karlijn J., van der Vaart, Carl H.
• Format: Article
• Language: English
• Subjects: Adult; Delivery, Obstetric; Female; Gynecology; Humans; Imaging, Three-Dimensional; Medicine; Medicine & Public Health; Original; Original Article; Pelvic Floor - diagnostic imaging; Postpartum Period - physiology; Pregnancy - physiology; Reference Values; Ultrasonography, Prenatal; Urology
• ISSN: 0937-3462; 1433-3023
• DOI: 10.1007/s00192-015-2905-4

Introduction and hypothesis Three-dimensional (3D) and four-dimensional (4D) volume transperineal ultrasound imaging is increasingly used to assess changes in the dimensions of the pelvic floor during pregnancy and after delivery. Little is known with regard to the area of the puborectalis muscle and its structural changes. Echogenicity measurement, a parameter that provides information on the structure of muscles, is increasingly used in orthopaedics and neuromuscular disease evaluation. This study is aimed at assessing the changes in the mean echogenicity of the puborectalis muscle (MEP) and the puborectalis muscle area (PMA) during first pregnancy and after childbirth. Methods The MEP and PMA of 254 women during first pregnancy were measured at 12 and 36 weeks’ gestation and 6 months postpartum. To determine the effect of child-birth on MEP and PMA, the results at 6 months postpartum were separately analysed for vaginal deliveries, operative vaginal deliveries (ventouse) and caesarean section deliveries. Mean differences in MEP and PMA were analysed using ANOVA statistics. Results The MEP at 6 months postpartum was, independent of manoeuvre, significantly ( p