OP14.02: Usefulness of three‐dimensional transperineal ultrasound in the evaluation of changes in the levator–urethra gaps with the mechanism of the partum

To evaluate the changes in the levator–urethra gap (LUG) according to the mechanism of the partum in women before the 8th week of pregnancy and after delivery. This prospective study included 201 women undergoing a transvaginal ultrasound examination before the eighth week of pregnancy and less than 6 months after giving birth from 2015 to 2017. Examination was performed with GE Healthcare (Milwaukee, USA) equipment using a multifrequency (3.2-10 MHZ) transvaginal volumetric probe. The acquisition should include: urethra, vagina and the anal canal entirely; capture angle was set to 120°, rendering a multiplanar volume of the perineum. This information was processed offline at a dedicated workstation using 4DView. Distance between the centre of the urethra and the medial aspect of the right and left muscle insertion on the inferior pubic ramus of the levator ani was performed, in contraction was measured. We correlated the results of LUG obtained in early pregnancy and in the postpartum according to each type of delivery care mechanism: spontaneous labour (SL), Caesarean birth (CB) and instrumental delivery (ID). LUG results (expressed as median in mm and standard deviation ()) of 201 women were shown in table 1 according the type of delivery in the early pregnancy and in the postpartum. There are significant differences between early pregnancy and postpartum for SL and ID (*: p < 0.05). The ultrasound evaluation of the LUG showed an increase between the early pregnancy and the postpartum period, especially in cases of spontaneous delivery and instrumental delivery. Although this difference, the values in postpartum period are below the cut-off of 25mm for diagnosing avulsion.