The correlation between the type of forceps application and the rate of levator ani muscle avulsion: A prospective cohort study.

Objectives: The association between the use of forceps and levator ani muscle (LAM) avulsion seems to be clear-cut. However, whether the lesion is due to the mechanical trauma yielded by the instrument or to the intrinsic complexity of this type of delivery, is yet to be determined. This study aims at determining the difference in LAM avulsion rate between Kielland rotational forceps and non-rotational forceps.

Can we predict levator ani muscle avulsion in instrumental deliveries through intrapartum transperineal ultrasound?

To determine whether intrapartum translabial ultrasound (ITU) is useful for the prediction of levator ani muscle (LAM) avulsions in instrumental deliveries (vacuum and forceps). Prospective, observational study, including (1/2016 - 5/2016) 77 nulliparous women, with singleton pregnancies of ≥37 weeks of gestation and with cephalic presentation, who required vacuum or forceps instrumentation to complete the delivery. The ITU parameters evaluated were Angle of Progression (AoP), Progression Distance (PD), Head Direction (HD), and Midline Angle (MLA), both at rest and with maternal push.

Influence of difficulty of instrumentation with vacuum on the rate of levator ani muscle avulsion identified by 3-4 d transperineal ultrasound.

Objectives: Evaluation of the influence of difficulty of instrumentation with vacuum on the rate of levator ani muscle (LAM) avulsions.

Materials And Methods: Prospective observational study with 86 nulliparous women with at term gestation who required instrumentation with vacuum to complete fetal extraction. After every delivery, each explorer reported the number of vacuum tractions needed to complete fetal extraction, as well as the subjective complexity of the instrumentation.

Evaluation of levator ani muscle throughout the different stages of labor by transperineal 3D ultrasound.

Objective: Description and assessment by 3-D transperineal ultrasound of modifications suffered by pelvic floor muscles during the passage of the fetal head through the birth canal during the second stage of labor, as well as the identification of the precise moment in which levator ani muscle avulsion takes place.

Materials And Methods: Patients included were 35 primigravidae, recruited during the first stage of labor, with at term pregnancy (37-42 weeks), without serious maternal-fetal pathology and cephalic presentation. A prospective observational study of 35 primigravidae, recruited during the first stage of labor, with at term pregnancy (37-42 weeks), with fetus in cephalic presentation and without serious maternal-fetal pathology.