Levator ani denervation and reinnervation 6 months after childbirth.
OBJECTIVE
The objective of the study was to assess the prevalence of levator ani denervation and reinnervation 6 months after the first delivery.


METHODS
Ninety-six primigravida women underwent quantitative electromyography of the levator ani during the third trimester and twice postpartum. A 95% confidence interval for normal function was created using interference pattern analysis. Fifty-seven who completed the study are presented in this secondary data analysis. Postpartum muscle sites outside the normal range were considered abnormal. Obstetric and demographic characteristics were assessed.


RESULTS
Of 57 subjects, 70% had no denervation. Of the 30% with denervation at 6 weeks, 35% recovered by 6 months. Obstetric or maternal characteristics were not predictive of denervation or reinnervation, except subjects with persistent denervation tended toward lower body mass index (BMI) independent of mode of delivery.


CONCLUSIONS
Nearly one-third of women have levator ani denervation after first delivery, but many recover by 6 months. Denervation is not clearly associated with mode of delivery, but higher maternal BMI may be protective.
South
Mary M T
MM
Division of Urogynecology and Pelvic Reconstructive Surgery, Department of Obstetrics and Gynecology, Duke University Medical Center, Durham, NC, USA.
Stinnett
Sandra S
SS
Sanders
Donald B
DB
Weidner
Alison C
AC
D000328:Adult; D015992:Body Mass Index; D002585:Cesarean Section / Q000009:adverse effects; D036861:Delivery, Obstetric / Q000009:adverse effects*; D004576:Electromyography; D005260:Female; D006801:Humans; D009135:Muscular Diseases / Q000175:diagnosis / Q000209:etiology* / Q000503:physiopathology*; D009416:Nerve Regeneration; D017773:Pelvic Floor / Q000294:innervation*; D049590:Postpartum Period; D011247:Pregnancy; D011263:Pregnancy Trimester, Third; D020127:Recovery of Function; D055815:Young Adult