title: Effect of levator ani muscle injury on primiparous women during the first year after childbirth.
abstract: OBJECTIVE
  To evaluate the effect of levator ani muscle (LAM) injury on pelvic floor disorders and health-related quality of life in Chinese primiparous women during the first year after delivery.
  
  
  METHODS
  At 8 weeks and 12 months after delivery, 328 women were assessed for symptoms of pelvic floor disorders and quality of life using the standardised questionnaire, POP-Q; and translabial ultrasound to detect LAM injury. Descriptive analysis, independent sample t test, non-parametric testing, Chi-squared test and two-sided Fisher's exact test were used.
  
  
  RESULTS
  At 8 weeks after delivery, 48 (19.0% [95% CI, 14.2-23.8%]) women with vaginal delivery had LAM injury; 38 women (79.2%) had persistent LAM injury at 12 months. At 8 weeks, LAM injury was associated with prolapse symptoms, descent at Pelvic Organ Prolapse Quantification (POP-Q) Aa and Ba points and a higher Pelvic Organ Prolapse Distress Inventory (POPDI) general and Urinary Distress Inventory (UDI) Obstructive subscale score. At 12 months, it was not associated with prolapse symptoms, Pelvic Floor Distress Inventory (PFDI) or Pelvic Floor Impact Questionnaire (PFIQ). There was also no association between stress urinary incontinence (SUI), urge urinary incontinence (UUI), mixed urinary incontinence (UI), faecal incontinence (FI) with LAM injury at both time points.
  
  
  CONCLUSIONS
  Seventy-nine per cent of women who had LAM injury at 8 weeks after vaginal delivery had persistent LAM injury at 12 months. LAM injury was associated with prolapse symptoms, lower POP-Q Aa and Ba points at 8 weeks after delivery and a higher POPDI general and UDI Obstructive subscale scoring. However, we are not able to confirm the association between LAM injury and SUI, UUI, mixed UI, FI at 8 weeks or 12 months after delivery; or prolapse symptoms, PFDI or PFIQ scores at 12 months after delivery.
authors.affiliation: Department of Obstetrics and Gynaecology, Faculty of Medicine, Chinese University of Hong Kong, Shatin, Hong Kong, symphorosa@cuhk.edu.hk.
authors.forename: Symphorosa S C
authors.initials: SS
authors.lastname: Chan
authors.forename: Rachel Y K
authors.initials: RY
authors.lastname: Cheung
authors.forename: K W
authors.initials: KW
authors.lastname: Yiu
authors.forename: L L
authors.initials: LL
authors.lastname: Lee
authors.forename: Tony K H
authors.initials: TK
authors.lastname: Chung
mesh_terms: D000328:Adult; D001003:Anal Canal / Q000293:injuries*; D044466:Asian People; D002681:China; D036861:Delivery, Obstetric; D005242:Fecal Incontinence / Q000208:ethnology*; D005260:Female; D006801:Humans; D010298:Parity; D017773:Pelvic Floor / Q000293:injuries*; D056887:Pelvic Organ Prolapse / Q000208:ethnology*; D011644:Puerperal Disorders / Q000208:ethnology*; D011788:Quality of Life; D011795:Surveys and Questionnaires; D013997:Time Factors; D014549:Urinary Incontinence / Q000208:ethnology*