Pelvic floor muscle variables and levator hiatus dimensions: a 3/4D transperineal ultrasound cross-sectional study on 300 nulliparous pregnant women

• Published in: International Urogynecology Journal Vol. 25; no. 10; pp. 1357 - 1361
• Main Authors: Bø, Kari, Hilde, Gunvor, Tennfjord, Merete Kolberg, Stær-Jensen, Jette, Siafarikas, Franziska, Engh, Marie Ellstrøm
• Format: Journal Article
• Language: English
• Published: London Springer London 01.10.2014; Springer Nature B.V
• Subjects: Adult; Body Mass Index; Cross-Sectional Studies; Female; Gynecology; Humans; Imaging, Three-Dimensional; Medicine; Medicine & Public Health; Muscle Contraction; Muscle Strength; Original Article; Parity; Pelvic Floor - diagnostic imaging; Pelvic Floor - physiopathology; Pregnancy; Pregnancy Complications - diagnosis; Pregnancy Complications - etiology; Pregnancy Complications - prevention & control; Ultrasonography, Prenatal; Urinary Incontinence - diagnosis; Urinary Incontinence - etiology; Urinary Incontinence - prevention & control; Urology; Vagina - diagnostic imaging; Vagina - physiopathology; Young Adult; Endurance; Pelvic floor muscles; Levator hiatus; Strength; Vaginal resting pressure
• ISSN: 0937-3462; 1433-3023
• DOI: 10.1007/s00192-014-2408-8

Introduction and hypothesis The aims of the present study were to investigate the correlation among vaginal resting pressure and pelvic floor muscle (PFM) strength and endurance, and the correlation between the same variables and levator hiatus (LH) dimensions in nulliparous pregnant women. Methods This was a cross-sectional study of 300 nulliparous pregnant women, mean age 28.7 years (SD 4.3) and pre-pregnancy BMI 23.9 kg/m 2 (SD 3.9), assessed at mean gestational week 20.8 (±1.4). Vaginal resting pressure and PFM strength and endurance were measured using a high precision pressure transducer connected to a vaginal balloon. LH dimensions (transverse and anterior–posterior diameters_ and LH area were assessed using 3/4D transperineal ultrasound in the axial plane of minimal hiatal dimensions using render mode. The Pearson correlation was used to analyze correlations among vaginal resting pressure and PFM strength and endurance, and between PFM variables and LH dimensions. Level of significance was set at 0.05. Results Pelvic floor muscle strength and vaginal resting pressure were significantly, but weakly correlated ( r  = 0.198, p  < 0.001). PFM strength and endurance showed a strong correlation ( r  = 0.929, p  < 0.001). High vaginal resting pressure was moderately correlated with a small LH area at rest ( r  = −0.451, p  < 0.001), but there was no significant correlation neither between PFM strength and LH area at rest ( r  = −0.012, p  = 0.84) nor between muscle endurance and LH area at rest ( r  = −0.014, p  = 0.81). A strong PFM contraction correlated moderately with reduction of the LH area ( r  = −0.367, p  < 0.001). Conclusions Pelvic floor muscle strength and endurance are strongly correlated, butdo not correlate with a smaller LH area at rest.