EP26.03: Transvaginal two‐dimensional sonographic assessment for detecting levator ani muscle trauma in women after childbirth

This study assesses the concordance between two-dimensional transvaginal ultrasound (2D-TVUS) and transperineal tomographic ultrasound imaging in diagnosing levator ani muscle (LAM) avulsion in postpartum women, alongside testing the repeatability of 2D-TVUS for measuring LAM thickness. In a retrospective analysis, postpartum women's ultrasound data sets were utilised to measure LAM thickness via 2D-TVUS at two postpartum intervals: 6-8 weeks and 3-6 months. The measurements focused on the attachment to the arcus tendineus levator ani and the middle part of the LAM. Intraobserver repeatability was assessed using intraclass correlation coefficients (ICCs). Avulsion detection was compared between 2D-TVUS and transperineal tomographic ultrasound imaging on 3D volume, with intermethod agreement evaluated by Cohen's kappa coefficient (k). LAM thickness measurements via 2D-TVUS demonstrated excellent and good intraobserver repeatability (ICC 0.84 and ICC 0.74, respectively). There was a high overall agreement of 92% (Cohen's kappa = 0.79) between 2D-TVUS and transperineal tomography. 2D-TVUS exhibited a diagnostic sensitivity of 91.7% and specificity of 92.1% for identifying LAM avulsion when compared to transperineal tomography. The 2D-TVUS is an effective and reliable method for the screening of LAM avulsion in postpartum women. Its simplicity and reproducibility make it a useful clinical tool for prompt assessment and management of pelvic floor disorders. Please note: The publisher is not responsible for the content or functionality of any supporting information supplied by the authors. Any queries (other than missing content) should be directed to the corresponding author for the article.