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In vivo measurement of the elastic properties of pelvic floor muscles in pregnancy using shear wave elastography

  • Maternal-Fetal Medicine
  • Published:
Archives of Gynecology and Obstetrics Aims and scope Submit manuscript

Abstract

Objective

We aimed to investigate changes in the elastic properties of levator ani muscle (LAM) and external anal sphincter (EAS) during pregnancy using shear wave elastography (SWE). Our secondary objective was to examine the association between the elastic properties of pelvic floor muscles (PFM) and perineal tears at childbirth.

Methods

This was a prospective monocentric study, including nulliparous women. Three visits were planned (14–18, 24–28, and 34–38 weeks) with a SWE assessment of the LAM and EAS at rest and during Valsalva maneuver. Then, we collected data about the delivery’s characteristics. Assessments were performed using an Aixplorer V12® device (SL 18–5 linear probe) using a transperineal approach, reporting the shear modulus in kPa. We looked for changes in PFM’s elastic properties during pregnancy using one-way ANOVA for repeated measures. We compared the mean shear modulus in late pregnancy for each muscle and condition between women with an intact perineum at delivery and those with a perineal tear using Student’s t test.

Results

Forty-seven women were considered. Forty-five women had vaginal delivery of which 38 (84.4%) had perineal tears. We did not report any significant changes in the elastic properties of PFM during pregnancy. Women with an intact perineum at delivery had a stiffer EAS at Valsalva maneuver in late pregnancy (27.0 kPa vs. 18.2 kPa; p < 0.005).

Conclusions

There were no significant changes in the elastic properties of the PFM in pregnancy. Stiffer EAS in late pregnancy appears to be associated with a lower incidence of perineal tears.

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Data availability

Data are available from the first author on reasonable request.

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Funding

There was no funding for this study.

Author information

Authors and Affiliations

  1. Department of Obstetrics and Gynecology, Poitiers University Hospital, Poitiers University, Poitiers, France

    Bertrand Gachon, Xavier Fritel & Fabrice Pierre

  2. Nantes Université, Movement-Interactions-Performance, MIP, UR4334, 44000, Nantes, France

    Bertrand Gachon & Antoine Nordez

  3. Poitiers University, INSERM CIC 1402, Poitiers University Hospital, Poitiers, France

    Bertrand Gachon & Xavier Fritel

  4. Clinique Bouchard, 77 Rue du Dr Escat, 13006, Marseille, France

    Bertrand Gachon

  5. Institut Universitaire de France (IUF), Paris, France

    Antoine Nordez

Authors
  1. Bertrand Gachon
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  4. Antoine Nordez
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Contributions

Each author of this work meets the criteria for authorship: BG contributed to the study design, performed shear wave elastography assessments, performed the analysis, and wrote each version of the main text of this manuscript; XF and FP contributed to statistical analysis, and review each version of the manuscript; AN contributed to the study design and data analysis, draft the work, and review each version of the manuscript.

Corresponding author

Correspondence to Bertrand Gachon.

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Gachon, B., Fritel, X., Pierre, F. et al. In vivo measurement of the elastic properties of pelvic floor muscles in pregnancy using shear wave elastography. Arch Gynecol Obstet 309, 2623–2631 (2024). https://doi.org/10.1007/s00404-023-07174-7

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  • DOI: https://doi.org/10.1007/s00404-023-07174-7

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