title: Longitudinal pelvic floor biometry: which factors affect it?
abstract: To evaluate pelvic floor biometry of women 3-5 years after their first delivery. The effect of a subsequent delivery and the mode of delivery on pelvic floor biometry were also studied.
  
  
  
  Three-hundred and twenty-eight women who had been examined by translabial ultrasound during their first singleton pregnancy and at 8 weeks and 1 year postpartum, were invited for a follow-up 3-5 years later. The positions of the bladder neck, cervix, anorectal junction and hiatal area (HA) were evaluated using translabial ultrasound. The effects of parity, mode of delivery and levator ani muscle avulsion were studied.
  
  
  
  A total of 240 women completed the study. Of these, 179 had one or more vaginal deliveries (VD) (VD-only group), 52 had one or more Cesarean sections (CS) (CS-only group) and nine had both VD and CS at follow-up. The mean interval between the first delivery and follow-up was 3.8 years. A significantly lower bladder neck and anorectal junction on Valsalva, a lower cervix at rest, on Valsalva and pelvic floor muscle contraction, and a greater HA were observed in the VD-only group at follow-up, compared with findings at 1 year of follow-up or in the first pregnancy. The findings were similar in the CS-only group, except without a lower anorectal junction on Valsalva. Compared with the primiparous VD-only group, a greater HA at rest was observed in the multiparous VD-only group (P = 0.027). The VD-only group had a greater HA than the CS-only group.
  
  
  
  At 3-5 years after first delivery, a lower bladder neck, cervix and anorectal junction, and a greater HA were observed compared with findings in the first trimester and at 1 year of follow-up, regardless of parity or mode of delivery. Women with two or more VDs had a greater HA compared with those who had only one VD, and women with at least one VD had a greater HA compared with those who delivered by CS only. Copyright © 2017 ISUOG. Published by John Wiley & Sons Ltd.
authors.affiliation: Department of Obstetrics & Gynaecology, Prince of Wales Hospital, Faculty of Medicine, The Chinese University of Hong Kong, Hong Kong SAR.
authors.forename: S S C
authors.identifier: 0000-0002-1452-488X
authors.initials: SSC
authors.lastname: Chan
authors.affiliation: Department of Obstetrics & Gynaecology, Prince of Wales Hospital, Faculty of Medicine, The Chinese University of Hong Kong, Hong Kong SAR.
authors.forename: R Y K
authors.identifier: 0000-0002-9829-3694
authors.initials: RYK
authors.lastname: Cheung
authors.affiliation: Department of Obstetrics & Gynaecology, Prince of Wales Hospital, Faculty of Medicine, The Chinese University of Hong Kong, Hong Kong SAR.
authors.forename: L L
authors.identifier: 0000-0003-1527-5704
authors.initials: LL
authors.lastname: Lee
authors.affiliation: Department of Obstetrics & Gynaecology, Prince of Wales Hospital, Faculty of Medicine, The Chinese University of Hong Kong, Hong Kong SAR.
authors.forename: T K H
authors.identifier: 0000-0002-6362-8546
authors.initials: TKH
authors.lastname: Chung
mesh_terms: D000328:Adult; D001003:Anal Canal / Q000000981:diagnostic imaging / Q000503:physiopathology; D044466:Asian People; D001699:Biometry; D002585:Cesarean Section / Q000009:adverse effects* / Q000706:statistics & numerical data; D036861:Delivery, Obstetric / Q000009:adverse effects* / Q000706:statistics & numerical data; D005260:Female; D005500:Follow-Up Studies; D006801:Humans; D010298:Parity / Q000502:physiology; D017773:Pelvic Floor / Q000000981:diagnostic imaging* / Q000503:physiopathology; D059952:Pelvic Floor Disorders / Q000000981:diagnostic imaging* / Q000209:etiology / Q000503:physiopathology; D011247:Pregnancy; D011248:Pregnancy Complications / Q000000981:diagnostic imaging* / Q000503:physiopathology; D011446:Prospective Studies; D013997:Time Factors; D014463:Ultrasonography; D001743:Urinary Bladder / Q000000981:diagnostic imaging / Q000503:physiopathology; D014549:Urinary Incontinence / Q000000981:diagnostic imaging* / Q000209:etiology / Q000503:physiopathology; D014636:Valsalva Maneuver / Q000502:physiology
keywords: bladder neck; cervix; hiatal area; levator ani muscle avulsion; pelvic floor biometry; second delivery