Multicenter study of the evolution of different types of avulsion over the 12 months after delivery

Objective: To perform a multicenter study of muscle recovery in levator ani muscle (LAM) avulsion during the first 12 months postpartum according to the type of LAM avulsion suffered. Methods: This was a multicenter prospective observational study including 242 pri miparas. Transperineal ultrasound...

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Autores: García Mejido, José Antonio, González Díaz, Enrique, Ortega, Ismael, Martín Martínez, Alicia, Fernández Palacín, Ana, Sáinz Bueno, José Antonio
Tipo de recurso: artículo
Estado:Versión publicada
Fecha de publicación:2022
País:España
Institución:Universidad de Sevilla (US)
Repositorio:idUS. Depósito de Investigación de la Universidad de Sevilla
OAI Identifier:oai:idus.us.es:11441/140140
Acceso en línea:https://hdl.handle.net/11441/140140
https://doi.org/10.1002/ijgo.14208
Access Level:acceso abierto
Palabra clave:Cervical elongation
Pelvic floor
Pelvic organ prolapse
Three-dimensional transperineal ultrasound
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spelling Multicenter study of the evolution of different types of avulsion over the 12 months after deliveryGarcía Mejido, José AntonioGonzález Díaz, EnriqueOrtega, IsmaelMartín Martínez, AliciaFernández Palacín, AnaSáinz Bueno, José AntonioCervical elongationPelvic floorPelvic organ prolapseThree-dimensional transperineal ultrasoundObjective: To perform a multicenter study of muscle recovery in levator ani muscle (LAM) avulsion during the first 12 months postpartum according to the type of LAM avulsion suffered. Methods: This was a multicenter prospective observational study including 242 pri miparas. Transperineal ultrasound was performed at 6 months and 12 months after delivery. Type I LAM avulsion was present when most of the lateral fibers of the pubo visceral muscle were observed at the muscle's insertion at the pubic level. Type II LAM avulsion was defined as complete detachment of the pubovisceral muscle from its insertion at the pubic level. Results: Among the 56 patients who completed the study (with ultrasound at 6 and 12 months after delivery), 76 avulsions (10 cases of bilateral avulsion) were identified at 6 months after delivery, and the total number of avulsions had decreased to 58 at 12 months after delivery (P < 0.001; 95% confidence interval [CI] 13.9%–33.5%). This decrease was due to the disappearance of 69.2% of the cases of Type I LAM avulsions (P < 0.001; 95% CI: 50.2%–88.2%). However, the number of Type II LAM avulsions remained constant at 6 months and 12 months after delivery. Conclusion: The spontaneous resolution of LAM avulsion during the first 12 months postpartum occurs in cases of Type I LAM avulsion but is not observed in Type II LAM avulsion.WILEYCirugíaMedicina Preventiva y Salud Pública2022info:eu-repo/semantics/articleinfo:eu-repo/semantics/publishedVersionapplication/pdfapplication/pdfhttps://hdl.handle.net/11441/140140https://doi.org/10.1002/ijgo.14208reponame:idUS. Depósito de Investigación de la Universidad de Sevillainstname:Universidad de Sevilla (US)InglésInternational journal of gynaecology and obstetrics: the official organ of the International Federation of Gynaecology and Obstetrics, 1-5.https://obgyn.onlinelibrary.wiley.com/doi/epdf/10.1002/ijgo.14208info:eu-repo/semantics/openAccessoai:idus.us.es:11441/1401402026-06-17T12:51:07Z
dc.title.none.fl_str_mv Multicenter study of the evolution of different types of avulsion over the 12 months after delivery
title Multicenter study of the evolution of different types of avulsion over the 12 months after delivery
spellingShingle Multicenter study of the evolution of different types of avulsion over the 12 months after delivery
García Mejido, José Antonio
Cervical elongation
Pelvic floor
Pelvic organ prolapse
Three-dimensional transperineal ultrasound
title_short Multicenter study of the evolution of different types of avulsion over the 12 months after delivery
title_full Multicenter study of the evolution of different types of avulsion over the 12 months after delivery
title_fullStr Multicenter study of the evolution of different types of avulsion over the 12 months after delivery
title_full_unstemmed Multicenter study of the evolution of different types of avulsion over the 12 months after delivery
title_sort Multicenter study of the evolution of different types of avulsion over the 12 months after delivery
dc.creator.none.fl_str_mv García Mejido, José Antonio
González Díaz, Enrique
Ortega, Ismael
Martín Martínez, Alicia
Fernández Palacín, Ana
Sáinz Bueno, José Antonio
author García Mejido, José Antonio
author_facet García Mejido, José Antonio
González Díaz, Enrique
Ortega, Ismael
Martín Martínez, Alicia
Fernández Palacín, Ana
Sáinz Bueno, José Antonio
author_role author
author2 González Díaz, Enrique
Ortega, Ismael
Martín Martínez, Alicia
Fernández Palacín, Ana
Sáinz Bueno, José Antonio
author2_role author
author
author
author
author
dc.contributor.none.fl_str_mv Cirugía
Medicina Preventiva y Salud Pública
dc.subject.none.fl_str_mv Cervical elongation
Pelvic floor
Pelvic organ prolapse
Three-dimensional transperineal ultrasound
topic Cervical elongation
Pelvic floor
Pelvic organ prolapse
Three-dimensional transperineal ultrasound
description Objective: To perform a multicenter study of muscle recovery in levator ani muscle (LAM) avulsion during the first 12 months postpartum according to the type of LAM avulsion suffered. Methods: This was a multicenter prospective observational study including 242 pri miparas. Transperineal ultrasound was performed at 6 months and 12 months after delivery. Type I LAM avulsion was present when most of the lateral fibers of the pubo visceral muscle were observed at the muscle's insertion at the pubic level. Type II LAM avulsion was defined as complete detachment of the pubovisceral muscle from its insertion at the pubic level. Results: Among the 56 patients who completed the study (with ultrasound at 6 and 12 months after delivery), 76 avulsions (10 cases of bilateral avulsion) were identified at 6 months after delivery, and the total number of avulsions had decreased to 58 at 12 months after delivery (P < 0.001; 95% confidence interval [CI] 13.9%–33.5%). This decrease was due to the disappearance of 69.2% of the cases of Type I LAM avulsions (P < 0.001; 95% CI: 50.2%–88.2%). However, the number of Type II LAM avulsions remained constant at 6 months and 12 months after delivery. Conclusion: The spontaneous resolution of LAM avulsion during the first 12 months postpartum occurs in cases of Type I LAM avulsion but is not observed in Type II LAM avulsion.
publishDate 2022
dc.date.none.fl_str_mv 2022
dc.type.none.fl_str_mv info:eu-repo/semantics/article
info:eu-repo/semantics/publishedVersion
format article
status_str publishedVersion
dc.identifier.none.fl_str_mv https://hdl.handle.net/11441/140140
https://doi.org/10.1002/ijgo.14208
url https://hdl.handle.net/11441/140140
https://doi.org/10.1002/ijgo.14208
dc.language.none.fl_str_mv Inglés
language_invalid_str_mv Inglés
dc.relation.none.fl_str_mv International journal of gynaecology and obstetrics: the official organ of the International Federation of Gynaecology and Obstetrics, 1-5.
https://obgyn.onlinelibrary.wiley.com/doi/epdf/10.1002/ijgo.14208
dc.rights.none.fl_str_mv info:eu-repo/semantics/openAccess
eu_rights_str_mv openAccess
dc.format.none.fl_str_mv application/pdf
application/pdf
dc.publisher.none.fl_str_mv WILEY
publisher.none.fl_str_mv WILEY
dc.source.none.fl_str_mv reponame:idUS. Depósito de Investigación de la Universidad de Sevilla
instname:Universidad de Sevilla (US)
instname_str Universidad de Sevilla (US)
reponame_str idUS. Depósito de Investigación de la Universidad de Sevilla
collection idUS. Depósito de Investigación de la Universidad de Sevilla
repository.name.fl_str_mv
repository.mail.fl_str_mv
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score 15.300724

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