title: Correlations of third-trimester hiatal biometry obtained using four-dimensional translabial ultrasonography with the delivery route in nulliparous pregnant women.
abstract: OBJECTIVE
  The goal of this study was to evaluate normal hiatal dimensions in the third trimester in nulliparous Thai pregnant women and to establish which biometric factors were associated with various pregnancy outcomes.
  
  
  METHODS
  Fifty-seven consecutive nulliparous pregnant Thai women in their third trimester were recruited on a voluntary basis from April to October 2014. All subjects underwent four-dimensional (4D) translabial ultrasonography. Hiatal biometric parameters were measured at rest, while performing a Valsalva maneuver, and during contraction. Information about the patients' eventual deliveries was obtained from their medical records.
  
  
  RESULTS
  The mean values of the patients' age, body mass index, and gestational age at the time of examination were 27.4±5.47 years, 26.7±3.48 kg/m(2), and 36.6±1.49 weeks, respectively. No subjects had vaginal lumps or experienced prolapse greater than stage 1 of the Pelvic Organ Prolapse Quantification system. Ultrasonography showed that the mean values of the hiatal area at rest, while performing a Valsalva maneuver, and during contraction were 13.10±2.92 cm(2), 17.50±4.81 cm(2), and 9.69±2.09 cm(2), respectively. The hiatal area at rest, the axial measurement at rest, and the axial measurement while performing a Valsalva maneuver were significantly associated with the route of delivery (P=0.02, P=0.04, and P=0.03, respectively).
  
  
  CONCLUSIONS
  The route of delivery was associated with hiatal biometric values measured using 4D translabial ultrasonography, based on the results of nulliparous Thai women in the third trimester.
authors.affiliation: Department of Obstetrics and Gynaecology, Faculty of Medicine, Khon Kaen University, Khon Kaen, Thailand.
authors.forename: Teerayut
authors.identifier: 0000-0001-9100-5840
authors.initials: T
authors.lastname: Temtanakitpaisan
authors.affiliation: Department of Obstetrics and Gynaecology, Bumrungrad Hospital, Bangkok, Thailand.
authors.forename: Varisara
authors.identifier: 0000-0003-4623-3996
authors.initials: V
authors.lastname: Chantarasorn
authors.affiliation: Department of Obstetrics and Gynaecology, Faculty of Medicine, Chulalongkorn University, Bangkok, Thailand.
authors.forename: Suvit
authors.identifier: 0000-0003-3544-1837
authors.initials: S
authors.lastname: Bunyavejchevin
keywords: Delivery, obstetric; Hiatal dimension; Ultrasonography, four-dimensional