title: Translabial three-dimensional ultrasound investigation of the levator hiatus in postpartum women.
abstract: OBJECTIVE
  This study utilized translabial three-dimensional ultrasound to investigate the morphological characteristics of the levator hiatus and provide sonographic evidence for assessing pelvic floor dysfunction in postpartum women.
  
  
  METHODS
  Two-hundred and one singleton primiparae without any complications underwent translabial three-dimensional ultrasound at 6 and 18 weeks after delivery, with 12 participants lost to follow-up at 18 weeks. Fifty nulliparae were enrolled as the control group. Levator hiatal morphology at rest and on Valsalva maneuver was assessed by experienced sonographers, specifically evaluating the anteroposterior diameter, left-to-right diameter, and area.
  
  
  RESULTS
  In postpartum women at 6 weeks after delivery, all the levator hiatal parameters were significantly higher compared with those of the control group. At 18 weeks, the hiatal parameters were better than at 6 weeks but still higher than in the nulliparous controls. In all three groups, the hiatal parameters were significantly higher during the Valsalva maneuver than at rest.
  
  
  CONCLUSIONS
  Postpartum women are prone to develop pelvic floor dysfunction as shown by an enlarged levator hiatus. Translabial three-dimensional ultrasound can be used to effectively assess the morphology and structural alterations of the levator hiatus in postpartum women, providing reliable pelvic floor imaging for early screening, diagnosis, and prevention of pelvic floor dysfunction.
authors.affiliation: Department of Ultrasound, Obstetrics and Gynecology Hospital of Fudan University, Shanghai, China.
authors.forename: Xue-Mei
authors.initials: XM
authors.lastname: Wang
authors.affiliation: Huai'an First People's Hospital, Nanjing Medical University, Jiangsu, China.
authors.forename: Xin
authors.initials: X
authors.lastname: Chang
authors.affiliation: Department of Gynecology, Obstetrics and Gynecology Hospital of Fudan University, Shanghai, China.
authors.forename: Yan
authors.initials: Y
authors.lastname: Ding
authors.affiliation: Department of Gynecology, Obstetrics and Gynecology Hospital of Fudan University, Shanghai, China.
authors.forename: Su-Zhen
authors.initials: SZ
authors.lastname: Wang
authors.affiliation: Huai'an First People's Hospital, Nanjing Medical University, Jiangsu, China.
authors.forename: Yin
authors.initials: Y
authors.lastname: Zhen
authors.affiliation: Department of Gynecology, Obstetrics and Gynecology Hospital of Fudan University, Shanghai, China.
authors.forename: Jing-Xin
authors.initials: JX
authors.lastname: Ding
authors.affiliation: Department of Ultrasound, Obstetrics and Gynecology Hospital of Fudan University, Shanghai, China. fanbin_kong1969@163.com.
authors.forename: Fan-Bin
authors.initials: FB
authors.lastname: Kong
mesh_terms: D000328:Adult; D005260:Female; D006801:Humans; D021621:Imaging, Three-Dimensional; D017773:Pelvic Floor / Q000000981:diagnostic imaging*; D049590:Postpartum Period; D014463:Ultrasonography / Q000379:methods; D014844:Vulva; D055815:Young Adult
keywords: Levator hiatus; Pelvic floor dysfunction; Postpartum; Three-dimensional ultrasound