Is levator hiatus distension associated with peripheral ligamentous laxity during pregnancy?

Introduction and hypothesis The impact of pregnancy on pelvic floor disorders remains poorly understood. During pregnancy, an increase in ligamentous laxity and pelvic organ mobility is often reported. Our main objective was to investigate a possible association between peripheral ligamentous laxity and levator hiatus (LH) distension during pregnancy. Methods This was a prospective longitudinal study of 26 pregnant women followed up from the first to the third trimester. We collected the following information: occurrence of pelvic organ prolapse (POP) symptoms (score higher than 0 for the POP section of the Pelvic Floor Distress Inventory 20 questions score), 4D perineal ultrasound scan results with LH distension assessment and measurement of metacarpophalangeal joint mobility (MCP laxity). The association between MCP laxity and LH distension was estimated by mixed multilevel linear regression. The associations between MCP laxity and categorical parameters were estimated in a multivariate analysis using a generalized estimating equation model. Results MCP laxity and LH distension were correlated with a correlation coefficient of 0.26 (p = 0.02), and 6.8% of the LH distension variance was explained by MCP laxity. In the multivariate analysis, MCP laxity was associated with POP symptoms with an odds ratio at 1.05 (95% CI 1.01–1.11) for an increase of 1° in MCP laxity. Conclusion LH distension and peripheral ligamentous laxity are significantly associated during pregnancy. However, the relationship is weak, and the results need to be confirmed in larger populations and with more specific techniques such as elastography to directly assess the elastic properties of the pelvic floor muscles..

Medienart:

E-Artikel

Erscheinungsjahr:

2017

Erschienen:

2017

Enthalten in:

Zur Gesamtaufnahme - volume:28

Enthalten in:

International urogynecology journal - 28(2017), 8 vom: 12. Jan., Seite 1223-1231

Sprache:

Englisch

Beteiligte Personen:

Gachon, Bertrand [VerfasserIn]
Fritel, Xavier [VerfasserIn]
Fradet, Laetitia [VerfasserIn]
Decatoire, Arnaud [VerfasserIn]
Lacouture, Patrick [VerfasserIn]
Panjo, Henri [VerfasserIn]
Pierre, Fabrice [VerfasserIn]
Desseauve, David [VerfasserIn]

Links:

Volltext [lizenzpflichtig]

BKL:

44.92$jGynäkologie

Themen:

Levator hiatus
Ligamentous laxity
Pelvic floor
Pelvic floor disorders
Pregnancy

Anmerkungen:

© The International Urogynecological Association 2017

doi:

10.1007/s00192-016-3252-9

funding:

Förderinstitution / Projekttitel:

PPN (Katalog-ID):

OLC2082873803

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