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Background <p>To evaluate whether induction of labor increases pelvic floor morphology alterations in terms of a larger levator hiatus area or presence of levator ani muscle avulsion and compartment prolapse after vaginal delivery based on 4D tomographic ultrasound imaging.</p> Materials and methods <p>The retrospective study included 676 women who delivered in our maternal medical center between February 2024 to March 2025. On the basis of mode of delivery, the participants were divided into two groups (spontaneous delivery group and induction of labor group). Data included patient characteristics, pregnancy parameters and delivery details were analyzed. The primary outcome was the imaging anatomical abnormalities, such as occurrence of levator ani muscle avulsion, large hiatus and compartment prolapse.</p> Results <p>On univariate analysis, no between-group differences in terms of levator ani muscle avulsion, anterior as well as central compartment prolapse were found (<i>P</i> &gt; 0.05), whereas significant differences on the measurements of levator hiatus area were observed between spontaneous delivery group and induction of labor group (<i>P</i> &lt; 0.05). After adjustment of confounding factors, multivariate logistic regression analysis shown no relationship between induction of labor and levator ani muscle avulsion, anterior as well as central compartment prolapse in this pilot (<i>P</i> &gt; 0.05); The analysis of covariance demonstrated a substantial association between induction of labor and an enlarged levator hiatus (<i>P</i> &lt; 0.05).</p> Conclusions <p>Induction of labor may have little influence on the sonographic finding of pelvic floor structure. However, induction of labor may be an indicator of increased risk of levator hiatus hyperdistensibility postpartum. Nevertheless, longitudinal cohort study is needed to establish whether antenatal differences in the levator hiatus area exist that may influence the results of induction of labor and the associated risk of levator hiatus enlargement postnatal.</p>

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Influence of induction of labor on morphological alterations in the pelvic floor after vaginal delivery determined by 4D transperineal ultrasound

  • 期刊论文

  • 出版模式：

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  • 发表日期：

    2025年10月15日

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  • Jiao Yi,
  • Zhiguo Tang,
  • Leilei Wang,
  • Bin Zhang,
  • Xianxia Chen,
  • Xiaoying Liu

摘要

Background

To evaluate whether induction of labor increases pelvic floor morphology alterations in terms of a larger levator hiatus area or presence of levator ani muscle avulsion and compartment prolapse after vaginal delivery based on 4D tomographic ultrasound imaging.

Materials and methods

The retrospective study included 676 women who delivered in our maternal medical center between February 2024 to March 2025. On the basis of mode of delivery, the participants were divided into two groups (spontaneous delivery group and induction of labor group). Data included patient characteristics, pregnancy parameters and delivery details were analyzed. The primary outcome was the imaging anatomical abnormalities, such as occurrence of levator ani muscle avulsion, large hiatus and compartment prolapse.

Results

On univariate analysis, no between-group differences in terms of levator ani muscle avulsion, anterior as well as central compartment prolapse were found (P > 0.05), whereas significant differences on the measurements of levator hiatus area were observed between spontaneous delivery group and induction of labor group (P < 0.05). After adjustment of confounding factors, multivariate logistic regression analysis shown no relationship between induction of labor and levator ani muscle avulsion, anterior as well as central compartment prolapse in this pilot (P > 0.05); The analysis of covariance demonstrated a substantial association between induction of labor and an enlarged levator hiatus (P < 0.05).

Conclusions

Induction of labor may have little influence on the sonographic finding of pelvic floor structure. However, induction of labor may be an indicator of increased risk of levator hiatus hyperdistensibility postpartum. Nevertheless, longitudinal cohort study is needed to establish whether antenatal differences in the levator hiatus area exist that may influence the results of induction of labor and the associated risk of levator hiatus enlargement postnatal.