- 33%-40% of women who deliver vaginally can expect a normal delivery without pelvic floor trauma.
Why this matters
- Undiagnosed pelvic floor trauma may be higher than previously thought.
- This information may be used as an indication for elective primary cesarean delivery (CD).
- 23% of cohort had CD.
- Of the vaginal deliveries (n=374), 21% had operative delivery and 4% had a third- or fourth-degree laceration.
- 51.9% had a "normal" vaginal delivery.
- Women with CD had no evidence of perineal trauma.
- Model 1:
- 27 women suffered an avulsion;
- 31 women had a residual sphincter defect on ultrasound; and
- 40% had a normal outcome.
- Model 2:
- 58 women had levator avulsion or sphincter defect;
- 33 had irreversible overdistension; and
- 33% had a normal outcome.
- Younger age and earlier gestation were associated with atraumatic normal delivery.
- Retrospective secondary analysis, data from a prior data set gathered in the context of an interventional perinatal imaging study.
- Primiparous women underwent interviews in the antepartum and postpartum periods, vaginal exams, and 4D translabial ultrasound to examine levator trauma and/or overdistension and residual sphincter defects (n=483).
- 2 models were used to diagnose trauma.
- Funding: None disclosed.
- Follow-up rate was only 76%.